Healthcare Provider Details

I. General information

NPI: 1598725400
Provider Name (Legal Business Name): JUST FOR KIDS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 09/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1233 45TH ST SUITE A-5
WEST PALM BEACH FL
33407-2160
US

IV. Provider business mailing address

1233 45TH ST SUITE A-5
WEST PALM BEACH FL
33407-2160
US

V. Phone/Fax

Practice location:
  • Phone: 561-863-7055
  • Fax: 561-863-6577
Mailing address:
  • Phone: 561-863-7055
  • Fax: 561-863-6577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number299991136
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number090634
License Number StateFL

VIII. Authorized Official

Name: MR. STUART R RUSSELL
Title or Position: VICE PRESIDENT
Credential:
Phone: 561-863-7055