Healthcare Provider Details
I. General information
NPI: 1497482020
Provider Name (Legal Business Name): PASSION 4 YOU, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/03/2022
Last Update Date: 07/14/2025
Certification Date: 07/14/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1702 TODDS LN STE 350
HAMPTON VA
23666-3210
US
IV. Provider business mailing address
1919 COMMERCE DR STE 160-B
HAMPTON VA
23666-4269
US
V. Phone/Fax
- Phone: 804-724-3287
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0855X |
| Taxonomy | Adolescent and Children Mental Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ASHLEE
M
FALLIN
Title or Position: CEO
Credential:
Phone: 804-724-3287