| Person Centered Place, Llc | |
|
4667 Haygood Rd # 506 Virginia Beach VA 23455-5444 | |
| (757) 227-6081 | |
| (757) 227-6082 |
| Full Name | Person Centered Place, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4667 Haygood Rd, Virginia Beach, Virginia |
| Authorized Official Name and Position | Juanda Antrum (CHIEF SERVICE OFFICER) |
| Authorized Official Contact | 7572276081 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Person Centered Place, Llc 4667 Haygood Rd # 506 Virginia Beach VA 23455-5444 Ph: (757) 227-6081 | Person Centered Place, Llc 4667 Haygood Rd # 506 Virginia Beach VA 23455-5444 Ph: (757) 227-6081 |
| NPI Number | 1912341926 |
|---|---|
| Provider Enumeration Date | 04/20/2013 |
| Last Update Date | 04/20/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912341926 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 1823-02-006 (Virginia) | Primary |
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