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General NPI Number Information
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NPI Number | 1306667530
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Entity Type | Organization
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Legal Business Name | JAMES RIVER ADULT SUPPORT SERVICES INC
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Dates
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Enumeration Date | 10/21/2024
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 4500 PORTSMOUTH BLVD STE 2B
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City | PORTSMOUTH
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State | VA
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Zip | 23701-2484
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Country | US
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Telephone | 757-704-6437
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Fax |
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Provider Business Mailing Address
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Address Line | 1412 MONARCH REACH
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City | CHESAPEAKE
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State | VA
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Zip | 23320-6423
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Country | US
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Telephone | 757-338-5756
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | BEVERLY A GRAY-BRITT
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Credential | LMHP-R MA
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Telephone | 757-704-6437
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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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