Provider Demographics
NPI:1528508223
Name:JV'S FOUNDATION CORP
Entity type:Organization
Organization Name:JV'S FOUNDATION CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:GLENDA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-352-9949
Mailing Address - Street 1:927 S GOLDWYN AVE
Mailing Address - Street 2:231
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32805-4324
Mailing Address - Country:US
Mailing Address - Phone:321-352-9949
Mailing Address - Fax:407-730-6124
Practice Address - Street 1:37 N ORANGE AVE
Practice Address - Street 2:500
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-2449
Practice Address - Country:US
Practice Address - Phone:321-352-9949
Practice Address - Fax:407-730-6124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health