Healthcare Provider Details

I. General information

NPI: 1225342819
Provider Name (Legal Business Name): MOVING FORWARD FAMILY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2010
Last Update Date: 08/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3219 EIGHT STAR WAY
CHESAPEAKE VA
23323-1174
US

IV. Provider business mailing address

3219 EIGHT STAR WAY
CHESAPEAKE VA
23323-1174
US

V. Phone/Fax

Practice location:
  • Phone: 757-285-5671
  • Fax: 757-485-7773
Mailing address:
  • Phone: 757-285-5671
  • Fax: 757-485-7773

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MISS DANIELLE GAIL
Title or Position: PRESIDENT
Credential:
Phone: 757-285-5671