Healthcare Provider Details

I. General information

NPI: 1508694555
Provider Name (Legal Business Name): SANDSTONE CARE VIRGINIA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2024
Last Update Date: 07/22/2024
Certification Date: 07/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5040 CORPORATE WOODS DR STE 120A
VIRGINIA BEACH VA
23462-4377
US

IV. Provider business mailing address

7555 E HAMPDEN AVE STE 103
DENVER CO
80231-4832
US

V. Phone/Fax

Practice location:
  • Phone: 757-244-9083
  • Fax:
Mailing address:
  • Phone: 720-372-1490
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PAUL GREESPAN
Title or Position: VP PAYOR RELATIONS
Credential:
Phone: 888-228-2384