Healthcare Provider Details

I. General information

NPI: 1063052579
Provider Name (Legal Business Name): LANDMARK RECOVERY OF NORFOLK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2020
Last Update Date: 06/15/2023
Certification Date: 06/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1516 HARMON ST
NORFOLK VA
23518-4056
US

IV. Provider business mailing address

720 COOL SPRINGS BLVD STE 500
FRANKLIN TN
37067-7259
US

V. Phone/Fax

Practice location:
  • Phone: 757-666-8136
  • Fax: 888-565-0442
Mailing address:
  • Phone: 855-950-5035
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: ALICIA NEAL
Title or Position: CONTRACTING SPECIALIST
Credential:
Phone: 615-281-9050