Provider Demographics
NPI:1629473681
Name:JUST RELAX LLC
Entity Type:Organization
Organization Name:JUST RELAX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JEANNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-850-2310
Mailing Address - Street 1:9363 SCARLET OAK DR
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-5669
Mailing Address - Country:US
Mailing Address - Phone:703-850-2310
Mailing Address - Fax:
Practice Address - Street 1:9363 SCARLET OAK DR
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-5669
Practice Address - Country:US
Practice Address - Phone:703-850-2310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-01
Last Update Date:2014-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0019001640225700000X
374K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty
No374K00000XNursing Service Related ProvidersReligious Nonmedical PractitionerGroup - Single Specialty