| Shaping Your Future Homes Llc | |
|
1312 Wirt Ave Portsmouth VA 23704-6950 | |
| (757) 528-2850 | |
| (757) 432-3159 |
| Full Name | Shaping Your Future Homes Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1312 Wirt Ave, Portsmouth, Virginia |
| Authorized Official Name and Position | Trisha Nardia Parker (CEO) |
| Authorized Official Contact | 7575282850 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shaping Your Future Homes Llc 4300 Portsmouth Blvd Unit 9183 Chesapeake VA 23321-0607 Ph: (757) 528-2850 | Shaping Your Future Homes Llc 1312 Wirt Ave Portsmouth VA 23704-6950 Ph: (757) 528-2850 |
| NPI Number | 1578242053 |
|---|---|
| Provider Enumeration Date | 07/13/2023 |
| Last Update Date | 09/06/2024 |
| Certification Date | 09/06/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578242053 | NPI | - | NPPES |
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