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General NPI Number Information
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NPI Number | 1427743921
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Entity Type | Organization
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Legal Business Name | URBAN LIFE COMMUNITY SERVICES
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Dates
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Enumeration Date | 04/10/2023
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Last Update Date | 04/18/2023
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Provider Practice Location Address
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Address Line | 5215 COLLEY AVE
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City | NORFOLK
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State | VA
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Zip | 23508-2166
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Country | US
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Telephone | 757-945-7527
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Fax | 757-956-1915
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Provider Business Mailing Address
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Address Line | 5215 COLLEY AVE
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City | NORFOLK
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State | VA
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Zip | 23508-2166
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Country | US
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Telephone | 757-945-7527
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Fax | 757-956-1915
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Authorized Official
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Title or Position | LICENSED CLINICIAN
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Name | TAKIYA TAYLOR
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Credential | LPC, LSATP
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Telephone | 757-753-1130
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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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