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General NPI Number Information
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NPI Number | 1235374430
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Entity Type | Organization
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Legal Business Name | D19CRISIS
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Dates
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Enumeration Date | 12/03/2008
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Last Update Date | 12/03/2008
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Provider Practice Location Address
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Address Line | 20 W BANK ST
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City | PETERSBURG
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State | VA
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Zip | 23803-3279
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Country | US
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Telephone | 804-541-6704
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Fax | 804-541-6708
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Provider Business Mailing Address
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Address Line | 20 W BANK ST
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City | PETERSBURG
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State | VA
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Zip | 23803-3279
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Country | US
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Telephone | 804-541-6704
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Fax | 804-541-6708
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Authorized Official
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Title or Position | EMERGENCY SERVICES MANANGER
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Name | MR. ROD TPSISTIS
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Credential | LPC
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Telephone | 804-541-6704
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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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