Provider Demographics
NPI:1871794529
Name:JONATHAN HERSH MANAGEMENT INC
Entity type:Organization
Organization Name:JONATHAN HERSH MANAGEMENT INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:STEFANKO
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:614-545-0316
Mailing Address - Street 1:5001 HORIZONS DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-5285
Mailing Address - Country:US
Mailing Address - Phone:614-545-0316
Mailing Address - Fax:614-451-4411
Practice Address - Street 1:5001 HORIZONS DR
Practice Address - Street 2:SUITE 203
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-5285
Practice Address - Country:US
Practice Address - Phone:614-545-0316
Practice Address - Fax:614-451-4411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2519055251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2519055Medicaid