Healthcare Provider Details

I. General information

NPI: 1659424448
Provider Name (Legal Business Name): HAMPTON NEWPORT NEWS COMMUNITY SERVICES BOARD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 03/14/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 MEDICAL DRIVE 2ND FLOOR
HAMPTON VA
23666-1765
US

IV. Provider business mailing address

300 MEDICAL DRIVE 2ND FLOOR
HAMPTON VA
23666-1765
US

V. Phone/Fax

Practice location:
  • Phone: 757-788-0300
  • Fax: 757-788-0969
Mailing address:
  • Phone: 757-788-0300
  • Fax: 757-788-0969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number019
License Number StateVA

VIII. Authorized Official

Name: DAPHNE CUNNINGHAM
Title or Position: EXECUTIVE DIRECTOR
Credential: PHD
Phone: 757-788-0300