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General NPI Number Information
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NPI Number | 1558298141
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Entity Type | Organization
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Legal Business Name | OUR EXTENDED FAMILY LLC
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Dates
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Enumeration Date | 05/06/2026
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Last Update Date | 05/06/2026
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Provider Practice Location Address
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Address Line | 7404 OAKMONT DR
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City | NORFOLK
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State | VA
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Zip | 23513-1012
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Country | US
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Telephone | 757-714-2255
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Fax |
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Provider Business Mailing Address
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Address Line | 6212 GENEVA WAY APT B
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City | NORFOLK
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State | VA
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Zip | 23513-1550
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Country | US
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Telephone | 757-714-2255
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | PATRICIA MONIQUE EDWARDS
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Credential |
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Telephone | 757-714-2255
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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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