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General NPI Number Information
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NPI Number | 1790176220
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Entity Type | Organization
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Legal Business Name | JUST IN TIME MENTAL HEALTH SERVICES
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Dates
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Enumeration Date | 02/05/2015
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Last Update Date | 02/05/2015
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Provider Practice Location Address
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Address Line | 501 N 6TH AVE
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City | HOPEWELL
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State | VA
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Zip | 23860-2618
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Country | US
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Telephone | 804-405-7175
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 37033
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23234-7033
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Country | US
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Telephone | 804-405-7175
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. CHARLES BAKER
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Credential |
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Telephone | 804-255-0925
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 93001001
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License Number State | VA
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