Jakes Place for Change, LLC

NPI #1104328012 in Rainbow City, Alabama

Provider Information

NPI Number: 1104328012
Entity Type: Organization
Organization Name: Jakes Place for Change, LLC
Primary Specialty: Community/Behavioral Health
Enumeration Date: Mar 6, 2018
Last Updated: Mar 6, 2018

Practice Location

Address: 116 CHURCH ST STE 4
City: Rainbow City
State: Alabama
ZIP Code: 35906-6287
Phone: (256) 459-5600

Authorized Official

Name: STEPHANIE LANE, MS COUNSELING, LBSW
Title: DIRECTOR/OWNER
Phone: (256) 459-5600

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Local Education Agency (LEA)	251300000X
Case Management	251B00000X
Public Health or Welfare	251K00000X
In Home Supportive Care	253Z00000X
Clinic/Center	261Q00000X
Clinic/Center - Community Health — Community Health	261QC1500X
Clinic/Center - Developmental Disabilities — Developmental Disabilities	261QD1600X
Clinic/Center - Family Planning, Non-Surgical — Family Planning, Non-Surgical	261QF0050X
Clinic/Center - Health Service — Health Service	261QH0100X
Clinic/Center - Adult Mental Health — Adult Mental Health	261QM0850X
Clinic/Center - Rehabilitation — Rehabilitation	261QR0400X
Clinic/Center - Research — Research	261QR1100X
Private Vehicle	347C00000X
Respite Care - Respite Care, Intellectual and/or Developmental Disabilities, Child — Respite Care, Intellectual and/or Developmental Disabilities, Child	385HR2060X
Community/Behavioral Health	251S00000X	Primary

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