| Cjab Family Services | |
|
1310 Airline Blvd Portsmouth VA 23707-4012 | |
| (757) 673-2950 | |
| (757) 673-2951 |
| Full Name | Cjab Family Services |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1310 Airline Blvd, Portsmouth, Virginia |
| Authorized Official Name and Position | Jenson Baker (CEO) |
| Authorized Official Contact | 7578176535 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cjab Family Services 1310 Airline Blvd Portsmouth VA 23707-4012 Ph: (757) 673-2950 | Cjab Family Services 1310 Airline Blvd Portsmouth VA 23707-4012 Ph: (757) 673-2950 |
| NPI Number | 1598185738 |
|---|---|
| Provider Enumeration Date | 04/25/2014 |
| Last Update Date | 04/25/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598185738 | NPI | - | NPPES |
| 1750639274 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 1765 (Virginia) | Primary |
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