Provider Demographics
NPI:1174297535
Name:UNIQUELY YOU SERVICES LLC
Entity Type:Organization
Organization Name:UNIQUELY YOU SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/EXECUTIVE PROGRAM DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:DONNELL
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:757-310-8329
Mailing Address - Street 1:3015 WEST AVE APT 103
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23607-3300
Mailing Address - Country:US
Mailing Address - Phone:757-310-8329
Mailing Address - Fax:
Practice Address - Street 1:617 74TH ST
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23605-2749
Practice Address - Country:US
Practice Address - Phone:757-310-8329
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-09
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities