Healthcare Provider Details

I. General information

NPI: 1841982584
Provider Name (Legal Business Name): PAYTONS PLACE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2023
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 TECH CENTER PKWY STE 200
NEWPORT NEWS VA
23606-3075
US

IV. Provider business mailing address

700 TECH CENTER PKWY STE 200
NEWPORT NEWS VA
23606-3075
US

V. Phone/Fax

Practice location:
  • Phone: 757-358-4381
  • Fax:
Mailing address:
  • Phone: 757-358-4381
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. SHARISSE STEPHANIE MARROW
Title or Position: CEO/OWNER
Credential:
Phone: 757-358-4381