Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Rehabilitation, Substance Use Disorder |
261QR0405X | |||
Community/Behavioral Health |
251S00000X |
| NPI Number | 1205583127 |
| LBN Legal business name | JX2 LLC |
| Authorized official | HEIDI WILLIAMS - (BILLING/CREDENTIALING) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 03/10/2022 |
| Last updated | 03/31/2022 - About 4 years ago |
| Identifiers | n/a |
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