| James Bentley Treatment Program | |
|
1520 High St Portsmouth VA 23704-3210 | |
| (757) 399-4742 | |
| Not Available |
| Full Name | James Bentley Treatment Program |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1520 High St, Portsmouth, Virginia |
| Authorized Official Name and Position | Sandra Pinnock (PRESIDENT) |
| Authorized Official Contact | 7573994742 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| James Bentley Treatment Program 1520 High St Portsmouth VA 23704-3210 Ph: (757) 399-4742 | James Bentley Treatment Program 1520 High St Portsmouth VA 23704-3210 Ph: (757) 399-4742 |
| NPI Number | 1396022323 |
|---|---|
| Provider Enumeration Date | 11/04/2011 |
| Last Update Date | 11/04/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396022323 | NPI | - | NPPES |
| 78203001 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 78203001 (Virginia) | Primary |
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