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Contact Information

JACY 2, LLC
319 CSAH #20
LITCHFIELD, MN55355
 Phone: 320-255-9530
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Substance Abuse Treatment, Children

3245S0500X
Indicates primary specialty

NPI Profile & details for JACY 2, LLC

NPI Number 1124212873
LBN Legal business name JACY 2, LLC
Authorized official CARMEN WILSON - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 09/05/2007
Last updated 09/05/2007 - About 19 years ago
Identifiers
MN License # 1047343
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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