Healthcare Provider Details

I. General information

NPI: 1154012599
Provider Name (Legal Business Name): NO LIMITS EASTERN SHORE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2023
Last Update Date: 05/17/2023
Certification Date: 05/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24546 COASTAL BLVD
TASLEY VA
23441-0259
US

IV. Provider business mailing address

PO BOX 259
TASLEY VA
23441-0259
US

V. Phone/Fax

Practice location:
  • Phone: 757-789-3990
  • Fax: 855-978-1967
Mailing address:
  • Phone: 757-789-3990
  • Fax: 855-978-1967

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: RACHEL EVANS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 757-789-3990