Provider Demographics
NPI:1356881551
Name:JAY'S HOUSE, INC
Entity type:Organization
Organization Name:JAY'S HOUSE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ADA
Authorized Official - Middle Name:MONET
Authorized Official - Last Name:CUNNINGHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-544-2333
Mailing Address - Street 1:25 N PENNEWELL DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19809-3313
Mailing Address - Country:US
Mailing Address - Phone:302-544-2333
Mailing Address - Fax:
Practice Address - Street 1:25 N PENNEWELL DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19809-3313
Practice Address - Country:US
Practice Address - Phone:302-544-2333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-07
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health