Provider Demographics
NPI:1265763528
Name:JUST US KIDZ INCORPORATED
Entity type:Organization
Organization Name:JUST US KIDZ INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:W
Authorized Official - Last Name:MARBLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-283-6368
Mailing Address - Street 1:393 DENBIGH BLVD
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23608-3758
Mailing Address - Country:US
Mailing Address - Phone:757-283-6368
Mailing Address - Fax:
Practice Address - Street 1:393 DENBIGH BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23608
Practice Address - Country:US
Practice Address - Phone:757-283-6368
Practice Address - Fax:757-283-6369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-26
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0157888360Medicaid
VA0159458006Medicaid
VA0159619110Medicaid