| Kjln Inc. | |
|
4020 Portsmouth Blvd Chesapeake VA 23321-2126 | |
| (757) 529-8844 | |
| (757) 525-4927 |
| Full Name | Kjln Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4020 Portsmouth Blvd, Chesapeake, Virginia |
| Authorized Official Name and Position | Nicholas Moyer (CEO) |
| Authorized Official Contact | 2768064418 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kjln Inc. 4208 Helen St Suffolk VA 23435-2138 Ph: (276) 806-4418 | Kjln Inc. 4020 Portsmouth Blvd Chesapeake VA 23321-2126 Ph: (757) 529-8844 |
| NPI Number | 1306491592 |
|---|---|
| Provider Enumeration Date | 08/05/2019 |
| Last Update Date | 02/20/2023 |
| Certification Date | 02/20/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306491592 | NPI | - | NPPES |
| 3316 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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