Healthcare Provider Details

I. General information

NPI: 1881145324
Provider Name (Legal Business Name): ARBRE DE VIE HEALTHCARE SERVICES PARTNERS, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2016
Last Update Date: 10/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5804 TAJO AVE
VIRGINIA BEACH VA
23455-4634
US

IV. Provider business mailing address

5804 TAJO AVE
VIRGINIA BEACH VA
23455-4634
US

V. Phone/Fax

Practice location:
  • Phone: 804-307-8580
  • Fax: 757-495-2505
Mailing address:
  • Phone: 804-307-8580
  • Fax: 757-495-2505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: MRS. YUREACIA D.N. PARKER
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 804-307-8580