1356854863 NPI number — JEANNE HOBBS CASE MANAGER, QMHS

Table of content: JEANNE HOBBS CASE MANAGER, QMHS (NPI 1356854863)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356854863 NPI number — JEANNE HOBBS CASE MANAGER, QMHS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOBBS
Provider First Name:
JEANNE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CASE MANAGER, QMHS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1356854863
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/07/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4464 S DIXIE HWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MIDDLETOWN
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45005-5464
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-649-8008
Provider Business Mailing Address Fax Number:
513-649-8004

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4464 S DIXIE HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIDDLETOWN
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45005-5464
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-649-8008
Provider Business Practice Location Address Fax Number:
513-649-8004
Provider Enumeration Date:
11/07/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 171M00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0074946 . This is a "ODMH" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 01-0693 . This is a "CARF" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: H130910 . This is a "PTAN GROUP" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0074861 . This is a "ODADAS" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".