Engaged N Purpose | |
4400 Bruce Farm Dr Suffolk VA 23435-1255 | |
(757) 537-2919 | |
Not Available |
Full Name | Engaged N Purpose |
---|---|
Speciality | Community/behavioral Health |
Location | 4400 Bruce Farm Dr, Suffolk, Virginia |
Authorized Official Name and Position | Fonda Althea Lyles (FOUNDER/CEO) |
Authorized Official Contact | 7575372919 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Engaged N Purpose Po Box 5012 Suffolk VA 23435-0012 Ph: (757) 537-2919 | Engaged N Purpose 4400 Bruce Farm Dr Suffolk VA 23435-1255 Ph: (757) 537-2919 |
NPI Number | 1447944426 |
---|---|
Provider Enumeration Date | 06/05/2023 |
Last Update Date | 06/05/2023 |
Certification Date | 06/01/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1447944426 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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