| J & J Maupin Enterprises Inc. | |
|
5310 E William Street Rd Decatur IL 62521-1874 | |
| (217) 422-6361 | |
| (217) 422-6365 |
| Full Name | J & J Maupin Enterprises Inc. |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 5310 E William Street Rd, Decatur, Illinois |
| Authorized Official Name and Position | Jeremy Ray Maupin (PRESIDENT) |
| Authorized Official Contact | 2174226361 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| J & J Maupin Enterprises Inc. 5310 E William Street Rd Decatur IL 62521-1874 Ph: (217) 422-6361 | J & J Maupin Enterprises Inc. 5310 E William Street Rd Decatur IL 62521-1874 Ph: (217) 422-6361 |
| NPI Number | 1104291905 |
|---|---|
| Provider Enumeration Date | 12/04/2015 |
| Last Update Date | 12/04/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104291905 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 149.016196 (Illinois) | Primary |
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