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General NPI Number Information
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NPI Number | 1750749735
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Entity Type | Organization
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Legal Business Name | Q'S AND POETIC'S SPECIAL EDUCATION AND FAMILY SUPPORT SERVICES LLC
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Dates
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Enumeration Date | 02/04/2016
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Last Update Date | 02/04/2016
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Provider Practice Location Address
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Address Line | 610 THIMBLE SHOALS BLVD STE 201D
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-4510
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Country | US
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Telephone | 757-591-8400
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Fax | 757-591-0900
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Provider Business Mailing Address
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Address Line | 610 THIMBLE SHOALS BLVD STE 201D
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-4510
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Country | US
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Telephone | 757-591-8400
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Fax | 757-591-0900
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Authorized Official
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Title or Position | CEO
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Name | MRS. CORA THOMAS JOHNSON
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Credential | AAPSY,BSHS/M,QMHP
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Telephone | 757-775-1612
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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 | 2640
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License Number State | VA
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