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General NPI Number Information
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NPI Number | 1356216808
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Entity Type | Organization
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Legal Business Name | LENA PON US CARING CENTER LLC
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Dates
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Enumeration Date | 10/06/2025
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 3612 PRUDEN BLVD
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City | SUFFOLK
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State | VA
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Zip | 23434-7204
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Country | US
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Telephone | 757-532-6564
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Fax |
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Provider Business Mailing Address
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Address Line | 818 TETON CIR
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City | SUFFOLK
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State | VA
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Zip | 23435-3390
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Country | US
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Telephone | 757-532-6564
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LATOYA A HARGROVE MARTIN
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Credential |
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Telephone | 757-532-6564
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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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