| Ta Mara's Promise, Llc | |
|
2601 West Ave Ste: 201 Newport VA 23607 | |
| (618) 204-0190 | |
| (757) 223-8100 |
| Full Name | Ta Mara's Promise, Llc |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 2601 West Ave, Newport, Virginia |
| Authorized Official Name and Position | Tamara Patrice Williams (OWNER/CEO) |
| Authorized Official Contact | 7577484048 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ta Mara's Promise, Llc 2601 West Ave Ste: 201 Newport VA 23607 Ph: (618) 204-0190 | Ta Mara's Promise, Llc 2601 West Ave Ste: 201 Newport VA 23607 Ph: (618) 204-0190 |
| NPI Number | 1790221802 |
|---|---|
| Provider Enumeration Date | 01/12/2017 |
| Last Update Date | 01/12/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790221802 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 0710102326 (Virginia) | Primary |
| 101YM0800X | Counselor - Mental Health | 070105823 (Virginia) | Secondary |