Provider Demographics
NPI:1033493713
Name:JUST4KIDZINC
Entity Type:Organization
Organization Name:JUST4KIDZINC
Other - Org Name:JUST 4 KIDZ ,INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-389-3963
Mailing Address - Street 1:11 S TEILMAN AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93706-1332
Mailing Address - Country:US
Mailing Address - Phone:281-078-2588
Mailing Address - Fax:
Practice Address - Street 1:823 W SUSSEX WAY
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93705-2021
Practice Address - Country:US
Practice Address - Phone:281-782-5887
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-29
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health