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General NPI Number Information
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NPI Number | 1710388475
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Entity Type | Organization
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Legal Business Name | C&E ADULT SERVICES INC.
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Dates
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Enumeration Date | 09/11/2014
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Last Update Date | 09/11/2014
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Provider Practice Location Address
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Address Line | 740 BOUSH ST
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City | NORFOLK
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State | VA
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Zip | 23510-1502
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Country | US
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Telephone | 832-381-0655
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Fax | 757-299-1921
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Provider Business Mailing Address
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Address Line | 4505 WINNIE DR
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City | CHESAPEAKE
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State | VA
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Zip | 23321-1592
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Country | US
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Telephone | 832-381-0655
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Fax | 757-299-1921
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Authorized Official
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Title or Position | OWNER/ CEO
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Name | MR. CLARENCE BAKER JR.
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Credential |
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Telephone | 832-381-0655
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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 | 2606
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License Number State | VA
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