Healthcare Provider Details

I. General information

NPI: 1477925659
Provider Name (Legal Business Name): GMA INTERVENTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2015
Last Update Date: 10/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

870 NORTH NEWTOWN RD SUITE 201
VIRGINIA BEACH VA
23462-1398
US

IV. Provider business mailing address

870 NORTH NEWTOWN RD SUITE 201
VIRGINIA BEACH VA
23462-1398
US

V. Phone/Fax

Practice location:
  • Phone: 757-490-1056
  • Fax: 757-490-1091
Mailing address:
  • Phone: 757-490-1056
  • Fax: 757-490-1091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number0710102083
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MELISSA ALEXANDER
Title or Position: COO
Credential: CSAC
Phone: 757-490-1056