| All Star Aba Va Llc | |
|
4410 Claiborne Sq E Ste 334 Hampton VA 23666-2074 | |
| (410) 541-1316 | |
| Not Available |
| Full Name | All Star Aba Va Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4410 Claiborne Sq E Ste 334, Hampton, Virginia |
| Authorized Official Name and Position | Shawn Tyberg (DIRECTOR) |
| Authorized Official Contact | 7186006604 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| All Star Aba Va Llc 4410 Claiborne Sq E Ste 334 Hampton VA 23666-2074 Ph: () - | All Star Aba Va Llc 4410 Claiborne Sq E Ste 334 Hampton VA 23666-2074 Ph: (410) 541-1316 |
| NPI Number | 1124881032 |
|---|---|
| Provider Enumeration Date | 02/02/2024 |
| Last Update Date | 02/02/2024 |
| Certification Date | 02/02/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124881032 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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