| Juno Promise Inc | |
|
4142 Queens Grant Rd Jamestown NC 27282-8732 | |
| (806) 220-3528 | |
| Not Available |
| Full Name | Juno Promise Inc |
|---|---|
| Speciality | Counselor |
| Location | 4142 Queens Grant Rd, Jamestown, North Carolina |
| Authorized Official Name and Position | Rose Bonner (OWNER) |
| Authorized Official Contact | 8062203528 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Juno Promise Inc 4142 Queens Grant Rd Jamestown NC 27282-8732 Ph: () - | Juno Promise Inc 4142 Queens Grant Rd Jamestown NC 27282-8732 Ph: (806) 220-3528 |
| NPI Number | 1124604012 |
|---|---|
| Provider Enumeration Date | 03/22/2021 |
| Last Update Date | 07/14/2024 |
| Certification Date | 07/14/2024 |
| Medicare PECOS PAC ID | 3779021480 |
|---|---|
| Medicare Enrollment ID | O20240813002257 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124604012 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Rose Lenore Bonner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1255741286 PECOS PAC ID: 4688112394 Enrollment ID: I20240813002402 |
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