Healthcare Provider Details

I. General information

NPI: 1225945330
Provider Name (Legal Business Name): REC ON DECK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4001 VIRGINIA BEACH BLVD STE 117 BOX 290
VIRGINIA BEACH VA
23452-1759
US

IV. Provider business mailing address

4001 VIRGINIA BEACH BLVD STE 117 #290
VIRGINIA BEACH VA
23452-1759
US

V. Phone/Fax

Practice location:
  • Phone: 757-822-0296
  • Fax:
Mailing address:
  • Phone: 757-822-0296
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. TAKEYRA COATS
Title or Position: FOUNDER, CTRS
Credential: PHD, CTRS
Phone: 757-822-0296