Healthcare Provider Details

I. General information

NPI: 1922751502
Provider Name (Legal Business Name): GUERISON SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2022
Last Update Date: 02/02/2022
Certification Date: 02/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3437 BRUIN DR
CHESAPEAKE VA
23321-4747
US

IV. Provider business mailing address

3437 BRUIN DR
CHESAPEAKE VA
23321-4747
US

V. Phone/Fax

Practice location:
  • Phone: 757-328-7908
  • Fax:
Mailing address:
  • Phone: 757-328-7908
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVID W HUNT
Title or Position: PRESIDENT
Credential:
Phone: 757-328-7908