Organization
J-JIREH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERTIE WILLIAMS CRUTE QP, LPN (DIRECTOR)
(252) 433-5103
Entity
Organization
Contact information
Practice address
188 SHOCCO SPRINGS RD, WARRENTON, NC 27589-8715
(252) 257-9909
Mailing address
188 SHOCCO SPRINGS RD, WARRENTON, NC 27589-8715
(252) 257-9909
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
1097604
NC
251C00000X
Developmentally Disabled Services Day Training Agency
1097604
NC
253Z00000X
In Home Supportive Care Agency
1097604
NC
347C00000X
Private Vehicle
1097604
NC
Other
Enumeration date
07/19/2010
Last updated
07/19/2010
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