| Residential Impact Services Llc | |
|
2715 Campostella Rd Chesapeake VA 23324-3656 | |
| (757) 372-7330 | |
| Not Available |
| Full Name | Residential Impact Services Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2715 Campostella Rd, Chesapeake, Virginia |
| Authorized Official Name and Position | Jarques Dorrell Hendricks (OWNER) |
| Authorized Official Contact | 7573727330 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Residential Impact Services Llc 4417 Templar Dr Portsmouth VA 23703-3925 Ph: (757) 372-7330 | Residential Impact Services Llc 2715 Campostella Rd Chesapeake VA 23324-3656 Ph: (757) 372-7330 |
| NPI Number | 1154164077 |
|---|---|
| Provider Enumeration Date | 06/18/2024 |
| Last Update Date | 06/18/2024 |
| Certification Date | 06/18/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154164077 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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