Provider Demographics
NPI:1699451641
Name:UNITED PROTECTION SERVICE
Entity type:Organization
Organization Name:UNITED PROTECTION SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JACAWAN
Authorized Official - Middle Name:JORDAN
Authorized Official - Last Name:DANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:SOCIAL WORK (BSW)
Authorized Official - Phone:716-260-1620
Mailing Address - Street 1:1020 OLIVER ST
Mailing Address - Street 2:
Mailing Address - City:NORTH TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-2710
Mailing Address - Country:US
Mailing Address - Phone:716-260-2040
Mailing Address - Fax:
Practice Address - Street 1:1020 OLIVER ST
Practice Address - Street 2:
Practice Address - City:NORTH TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14120-2710
Practice Address - Country:US
Practice Address - Phone:716-260-2040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)