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General NPI Number Information
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NPI Number | 1316715691
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Entity Type | Organization
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Legal Business Name | SCL COMMUNITY CARE PARTNER
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Dates
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Enumeration Date | 12/15/2023
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Last Update Date | 01/14/2024
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Provider Practice Location Address
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Address Line | 2658 WINGFIELD RD
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City | NORFOLK
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State | VA
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Zip | 23518-4655
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Country | US
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Telephone | 757-239-1100
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Fax |
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Provider Business Mailing Address
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Address Line | 2658 WINGFIELD RD
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City | NORFOLK
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State | VA
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Zip | 23518-4655
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Country | US
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Telephone | 757-239-1100
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Fax |
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Authorized Official
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Title or Position | SERVICE FACILITATOR
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Name | SHARON COOPER-LEWIS
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Credential |
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Telephone | 757-239-1100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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