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General NPI Number Information
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NPI Number | 1134374622
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Entity Type | Organization
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Legal Business Name | EMPTY ARMS OUTREACH MINISTRY, INC.
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Dates
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Enumeration Date | 11/25/2008
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Last Update Date | 11/25/2008
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Provider Practice Location Address
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Address Line | 4526 BRICKWOOD MEADOW CT
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City | PETERSBURG
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State | VA
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Zip | 23803-8866
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Country | US
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Telephone | 804-861-0596
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Fax | 804-861-1239
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Provider Business Mailing Address
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Address Line | 4725 WOODSTREAM DR
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City | PETERSBURG
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State | VA
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Zip | 23803-8801
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Country | US
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Telephone | 804-862-4036
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Fax | 804-861-1239
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. JOY M. COMBS-MARSHALL
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Credential | LRP, SW, BA
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Telephone | 804-862-4036
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | SS14106, SS164/32608
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | SS164/326-08, SS1410
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License Number State | VA
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