Western Tidewater Community Services Board | |
5268 Godwin Blvd Suffolk VA 23434-8135 | |
(757) 255-7100 | |
Not Available |
Full Name | Western Tidewater Community Services Board |
---|---|
Speciality | Clinic/center - Adolescent And Children Mental Health |
Location | 5268 Godwin Blvd, Suffolk, Virginia |
Authorized Official Name and Position | Emily Bowe Hughes (CLINICIAN) |
Authorized Official Contact | 7572557113 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Western Tidewater Community Services Board 5268 Godwin Blvd Suffolk VA 23434-8135 Ph: (757) 255-7100 | Western Tidewater Community Services Board 5268 Godwin Blvd Suffolk VA 23434-8135 Ph: (757) 255-7100 |
NPI Number | 1164416533 |
---|---|
Provider Enumeration Date | 08/31/2005 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1164416533 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0855X | Clinic/center - Adolescent And Children Mental Health | 0904002622 (Virginia) | Primary |
News Archive
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