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General NPI Number Information
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NPI Number | 1619850344
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Entity Type | Organization
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Legal Business Name | TIDE TOGETHER WELLNESS & SUPPORT LLC
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Dates
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Enumeration Date | 07/29/2025
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 2 CONSTITUTION DR
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-3456
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Country | US
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Telephone | 704-661-3327
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Fax |
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Provider Business Mailing Address
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Address Line | 168 CAROL PL
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City | DOUGLASVILLE
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State | GA
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Zip | 30134-7312
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Country | US
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Telephone | 704-661-3327
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SABRINA BETTS
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Credential |
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Telephone | 704-661-3327
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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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