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General NPI Number Information
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NPI Number | 1205657517
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Entity Type | Organization
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Legal Business Name | OPPORTUNITY VILLAGE AND HEALING SERVICES
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Dates
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Enumeration Date | 10/19/2024
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 7618 CORAL KEY DR
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City | CYPRESS
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State | TX
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Zip | 77433-6282
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Country | US
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Telephone | 336-534-1780
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Fax |
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Provider Business Mailing Address
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Address Line | 11407 LYNDENWOOD CT
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City | CHESTERFIELD
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State | VA
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Zip | 23838-5263
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Country | US
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Telephone | 336-534-1780
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RICARDO MARSH
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Credential |
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Telephone | 336-534-1780
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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