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General NPI Number Information
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NPI Number | 1336395359
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Entity Type | Organization
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Legal Business Name | ALTERNATIVE FAMILY TREATMENT SERVICES, INC
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Dates
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Enumeration Date | 08/11/2008
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Last Update Date | 08/11/2008
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Provider Practice Location Address
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Address Line | 7510 GRANBY ST SUITE 6
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City | NORFOLK
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State | VA
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Zip | 23505-3437
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Country | US
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Telephone | 757-587-5615
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Fax | 757-587-5639
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Provider Business Mailing Address
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Address Line | 7510 GRANBY ST SUITE 6
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City | NORFOLK
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State | VA
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Zip | 23505-3437
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Country | US
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Telephone | 757-587-5615
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Fax | 757-587-5639
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR/OWNER
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Name | MRS. BETTY GRAY-HENSON
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Credential | M.S.W., A.C.S.W.
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Telephone | 757-587-5615
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | 690-05-001
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License Number State | VA
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