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General NPI Number Information
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NPI Number | 1679337323
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Entity Type | Organization
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Legal Business Name | KREATIVE MILESTONES BEHAVIORAL HEALTHCARE SERVICES LLC
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Dates
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Enumeration Date | 02/12/2024
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 732 THIMBLE SHOALS BLVD STE 202
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-4262
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Country | US
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Telephone | 757-753-5812
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Fax | 888-469-5019
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Provider Business Mailing Address
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Address Line | 732 THIMBLE SHOALS BLVD STE 202
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-4262
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Country | US
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Telephone | 757-753-5812
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Fax | 888-469-5019
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Authorized Official
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Title or Position | OWNER/CEO
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Name | CAMEO T HARRIS
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Credential | LCSW
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Telephone | 757-753-5812
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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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