NPI Code Details Logo

NPI 1386511624

NPI 1386511624 : SIMPATICO LLC : PORTSMOUTH, VA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1386511624
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    SIMPATICO LLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    10/21/2025
-----------------------------------------------------
    Last Update Date     |    10/21/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    5016 OAKHILL AVE 
-----------------------------------------------------
    City                 |    PORTSMOUTH
-----------------------------------------------------
    State                |    VA
-----------------------------------------------------
    Zip                  |    23703-5215
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    757-352-1854
-----------------------------------------------------
    Fax                  |    757-352-1854
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    5016 OAKHILL AVE 
-----------------------------------------------------
    City                 |    PORTSMOUTH
-----------------------------------------------------
    State                |    VA
-----------------------------------------------------
    Zip                  |    23703-5215
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    757-352-1854
-----------------------------------------------------
    Fax                  |    757-352-1854
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    CEO
-----------------------------------------------------
    Name                 |     JOHN  FOWLER 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    757-352-1854
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    251C00000X
-----------------------------------------------------
    Taxonomy Name        |    Developmentally Disabled Services Day Training Agency
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.