1639513781 NPI number — CITY OF VIRGINIA BEACH HUMAN SERVICES

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639513781 NPI number — CITY OF VIRGINIA BEACH HUMAN SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF VIRGINIA BEACH HUMAN SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1639513781
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/18/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3432 VIRGINIA BEACH BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VIRGINIA BEACH
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23452-4420
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-385-0687
Provider Business Mailing Address Fax Number:
757-306-5801

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2525 LIFETIME CIR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VIRGINIA BEACH
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23456-1499
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-385-5575
Provider Business Practice Location Address Fax Number:
757-416-5083
Provider Enumeration Date:
04/19/2013

Additional Information

Authorized Official

Authorized Official Last Name:
BAILEY
Authorized Official First Name:
MARGARET
Authorized Official Middle Name:
G
Authorized Official Title or Position:
REIMBURSEMENT MANAGER
Authorized Official Telephone Number:
757-385-0687

Provider Taxonomy Codes

  • Taxonomy code: 310500000X , with the licence number:  26101001 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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