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General NPI Number Information
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NPI Number | 1174759047
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Entity Type | Organization
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Legal Business Name | COMMUNITY EDUCATION CENTERS
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Dates
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Enumeration Date | 06/05/2009
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Last Update Date | 06/05/2009
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Provider Practice Location Address
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Address Line | 801 SANDERSON RD
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City | CHESAPEAKE
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State | VA
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Zip | 23322-2075
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Country | US
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Telephone | 757-421-0095
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Fax | 757-421-7124
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Provider Business Mailing Address
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Address Line | 840 SOMMERVILLE CRES
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City | CHESAPEAKE
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State | VA
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Zip | 23320-4841
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | MR. JAMES CALVIN WILLIS SR.
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Credential | M.S., LPC
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Telephone | 757-739-1703
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 0701003547
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 3810
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License Number State | NC
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