Most Relevant Information
Provider Data
| NPI Number: | 1003456427 |
| Provider Name: | JAKE FORD |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/14/2020 |
| Last Updated: | 01/14/2020 |
Provider Practice Location
1815 PLEASANT GROVE RD
JONESBORO
AR
724057870
Practice Location Phone/Fax
| Phone: | 8709336886 |
| Fax: | 8709339395 |
Provider Mailing Location
1815 PLEASANT GROVE RD
JONESBORO
AR
724057870
Provider Mailing Phone/Fax
| Phone: | 8709336886 |
| Fax: | 8709339395 |