Provider Demographics
NPI:1487422762
Name:JEWELS OF PURPOSE SUPPORTED LIVING
Entity type:Organization
Organization Name:JEWELS OF PURPOSE SUPPORTED LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-390-9716
Mailing Address - Street 1:1131 FAIRWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:OH
Mailing Address - Zip Code:43213-2522
Mailing Address - Country:US
Mailing Address - Phone:614-390-9716
Mailing Address - Fax:
Practice Address - Street 1:1131 FAIRWAY BLVD
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:OH
Practice Address - Zip Code:43213-2522
Practice Address - Country:US
Practice Address - Phone:614-390-9716
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-15
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities