Community S.h.a.r.e., Llc | |
762 Independence Blvd Ste 100c Virginia Beach VA 23455-6250 | |
(757) 644-4192 | |
(757) 644-4196 |
Full Name | Community S.h.a.r.e., Llc |
---|---|
Speciality | Community/behavioral Health |
Location | 762 Independence Blvd Ste 100c, Virginia Beach, Virginia |
Authorized Official Name and Position | Jayson Johnson (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 7576444192 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Community S.h.a.r.e., Llc 1920 Centerville Tpke # 117-247 Virginia Beach VA 23464-6800 Ph: () - | Community S.h.a.r.e., Llc 762 Independence Blvd Ste 100c Virginia Beach VA 23455-6250 Ph: (757) 644-4192 |
NPI Number | 1962748830 |
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Provider Enumeration Date | 12/21/2012 |
Last Update Date | 12/21/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1962748830 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | 1807 (Virginia) | Primary |
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