| Mary's Home Inc | |
|
4020 Portsmouth Blvd Chesapeake VA 23321-2126 | |
| (757) 529-8844 | |
| Not Available |
| Full Name | Mary's Home Inc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 4020 Portsmouth Blvd, Chesapeake, Virginia |
| Authorized Official Name and Position | Krystal Clanton (CEO) |
| Authorized Official Contact | 7575298844 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mary's Home Inc 4020 Portsmouth Blvd Chesapeake VA 23321-2126 Ph: (757) 529-8844 | Mary's Home Inc 4020 Portsmouth Blvd Chesapeake VA 23321-2126 Ph: (757) 529-8844 |
| NPI Number | 1437871753 |
|---|---|
| Provider Enumeration Date | 09/13/2022 |
| Last Update Date | 10/11/2024 |
| Certification Date | 10/11/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437871753 | NPI | - | NPPES |
| 3827 | Other | VA | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 320800000X | Community Based Residential Treatment Facility, Mental Illness | (* (Not Available)) | Secondary |
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