Provider Demographics
NPI:1992544902
Name:JUPRIES HAVEN LLC
Entity type:Organization
Organization Name:JUPRIES HAVEN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JUDE
Authorized Official - Middle Name:AZHINUE
Authorized Official - Last Name:NEBA
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:614-390-0145
Mailing Address - Street 1:4088 BRACKENWOOD TRL
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43228-8437
Mailing Address - Country:US
Mailing Address - Phone:614-390-0145
Mailing Address - Fax:
Practice Address - Street 1:4088 BRACKENWOOD TRL
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-8437
Practice Address - Country:US
Practice Address - Phone:614-390-0145
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health