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Organization
NICOLE BROOKE JAMES
Active
Organization
NICOLE BROOKE JAMES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS NICOLE BROOKE JAMES LPN-IV (LPN-IV)
(740) 352-4421
Entity
Organization
Contact information
Practice address
4050 STATE ROUTE 139, PORTSMOUTH, OH 45662-8629
(740) 352-4421
Mailing address
4050 STATE ROUTE 139, PORTSMOUTH, OH 45662-8629
(740) 352-4421
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
PN.148781-M-IV
OH
385HR2055X
Child Mental Illness Respite Care
PN.148781-M-IV
OH
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
PN.148781-M-IV
OH
385HR2065X
Child Physical Disabilities Respite Care
PN.148781-M-IV
OH
Other
Enumeration date
05/04/2012
Last updated
05/04/2012
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