Organization Name: | EVOLVE THERAPEUTIC COUNSELING SERVICES, LLC |
NPI Number: | 1962688341 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | VICTOR M MOODY (VICE PRESIDENT) |
Mailing Address: | 2021b Cunningham Dr Suite 2 Hampton |
State: | VA US |
Postal Code: | 236663326 |
Phone Number: | 7572247986 |
Fax Number: | 7572248321 |
NPI Enumeration Date: | 01/15/2008 |
NPI Last Update Date: | 01/15/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320800000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Community Based Residential Treatment Facility, Mental Illness |
Taxonomy Specialization: | |
Taxonomy Definition: | A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |