Provider Demographics
NPI:1497877401
Name:JS UNLIMITED INC
Entity Type:Organization
Organization Name:JS UNLIMITED INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHILDRESS
Authorized Official - Suffix:
Authorized Official - Credentials:LBSW,LPC
Authorized Official - Phone:979-575-7949
Mailing Address - Street 1:307 S MAIN ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77803-6948
Mailing Address - Country:US
Mailing Address - Phone:979-575-7949
Mailing Address - Fax:979-779-8522
Practice Address - Street 1:307 S MAIN ST
Practice Address - Street 2:SUITE 205
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77803-6948
Practice Address - Country:US
Practice Address - Phone:979-779-2864
Practice Address - Fax:979-779-8522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14921101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty