Provider Demographics
NPI:1285060111
Name:JFM INSPIRATIONS COUNSELING SERVICES
Entity type:Organization
Organization Name:JFM INSPIRATIONS COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:SANOVA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-343-0086
Mailing Address - Street 1:2427 N 71ST AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85035-2611
Mailing Address - Country:US
Mailing Address - Phone:623-251-5953
Mailing Address - Fax:623-256-6992
Practice Address - Street 1:2427 N 71ST AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85035-2611
Practice Address - Country:US
Practice Address - Phone:623-251-5953
Practice Address - Fax:623-256-6992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-24
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBH-4296323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ769208Medicaid