Provider Demographics
NPI:1710629001
Name:JUTISO, INC.
Entity Type:Organization
Organization Name:JUTISO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER & COO
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-362-7093
Mailing Address - Street 1:440 MONTICELLO AVE STE 1802
Mailing Address - Street 2:#45790
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23510
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:440 MONTICELLO AVE STE 1802
Practice Address - Street 2:#45790
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510
Practice Address - Country:US
Practice Address - Phone:508-202-1011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-08
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)