Provider Demographics
NPI:1336978287
Name:JADED UNRPOTECTED VOLATILE YOUTH SERVICES, LLC
Entity type:Organization
Organization Name:JADED UNRPOTECTED VOLATILE YOUTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NATASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-632-0076
Mailing Address - Street 1:7850 PETER HOOVER RD
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:OH
Mailing Address - Zip Code:43054-9723
Mailing Address - Country:US
Mailing Address - Phone:614-290-2637
Mailing Address - Fax:
Practice Address - Street 1:2650 W BROAD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43204-3329
Practice Address - Country:US
Practice Address - Phone:614-290-2637
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-30
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist