| Jem Therapeutic Services Llc | |
|
8310 Nw 47th St Lauderhill FL 33351-5535 | |
| (703) 981-1078 | |
| Not Available |
| Full Name | Jem Therapeutic Services Llc |
|---|---|
| Speciality | Social Worker |
| Location | 8310 Nw 47th St, Lauderhill, Florida |
| Authorized Official Name and Position | Marcia Johnson (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 7039811078 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jem Therapeutic Services Llc 8310 Nw 47th St Lauderhill FL 33351-5535 Ph: (703) 981-1078 | Jem Therapeutic Services Llc 8310 Nw 47th St Lauderhill FL 33351-5535 Ph: (703) 981-1078 |
| NPI Number | 1225783814 |
|---|---|
| Provider Enumeration Date | 02/13/2022 |
| Last Update Date | 12/02/2024 |
| Certification Date | 12/02/2024 |
| Medicare PECOS PAC ID | 9436546892 |
|---|---|
| Medicare Enrollment ID | O20220504000016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225783814 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Marcia Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104426220 PECOS PAC ID: 4688051774 Enrollment ID: I20220511000283 |
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