Organization
CJAB & CJAB LLC
Active
Other names
CJAB Family Services
Organization subpart
No
Provider details
NPI number
Authorized official
JENSON BAKER (CEO)
(757) 817-6535
Entity
Organization
Contact information
Practice address
1310 AIRLINE BLVD, PORTSMOUTH, VA 23707-4012
(757) 673-2950
(757) 673-2951
Mailing address
1310 AIRLINE BLVD, PORTSMOUTH, VA 23707-4012
(757) 673-2950
(757) 673-2951
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1765
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1750639274
—
VA
Enumeration date
04/25/2014
Last updated
04/25/2014
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