| Broadus International Group Network, Llc | |
|
110 Coliseum Crossing #5050 Hampton VA 23666-5971 | |
| (757) 785-4424 | |
| (757) 785-4424 |
| Full Name | Broadus International Group Network, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 110 Coliseum Crossing, Hampton, Virginia |
| Authorized Official Name and Position | Katesha Broadus (CEO/FOUNDER) |
| Authorized Official Contact | 2404472505 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Broadus International Group Network, Llc 110 Coliseum Xing # 5050 Hampton VA 23666-5971 Ph: (757) 778-9800 | Broadus International Group Network, Llc 110 Coliseum Crossing #5050 Hampton VA 23666-5971 Ph: (757) 785-4424 |
| NPI Number | 1295253805 |
|---|---|
| Provider Enumeration Date | 09/03/2017 |
| Last Update Date | 11/03/2023 |
| Certification Date | 11/03/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295253805 | NPI | - | NPPES |
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