| Footprint, Llc | |
|
5728 Constance Ct Virginia Beach VA 23462-1063 | |
| (757) 339-7799 | |
| Not Available |
| Full Name | Footprint, Llc |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 5728 Constance Ct, Virginia Beach, Virginia |
| Authorized Official Name and Position | Fitzroy Smith (PRESIDENT) |
| Authorized Official Contact | 7573397799 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Footprint, Llc 5728 Constance Ct Virginia Beach VA 23462-1063 Ph: () - | Footprint, Llc 5728 Constance Ct Virginia Beach VA 23462-1063 Ph: (757) 339-7799 |
| NPI Number | 1568967800 |
|---|---|
| Provider Enumeration Date | 03/28/2018 |
| Last Update Date | 03/28/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568967800 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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