Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Rehabilitation, Substance Use Disorder |
261QR0405X |
| NPI Number | 1356968895 |
| LBN Legal business name | JENNDA LLC |
| Authorized official | JENNIFER HAWKINS - (CO-OWNER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 07/01/2020 |
| Last updated | 07/01/2020 - About 6 years ago |
| Identifiers | n/a |
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