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General NPI Number Information
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NPI Number | 1811483464
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Entity Type | Organization
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Legal Business Name | MCCLENNEY FAMILY VALUES, LLC
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Dates
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Enumeration Date | 07/06/2018
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Last Update Date | 12/30/2023
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Provider Practice Location Address
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Address Line | 909 STATE ST
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City | CHESAPEAKE
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State | VA
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Zip | 23323-5914
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Country | US
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Telephone | 757-469-0406
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Fax | 757-966-1234
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Provider Business Mailing Address
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Address Line | PO BOX 62232
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City | VIRGINIA BEACH
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State | VA
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Zip | 23466-2232
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Country | US
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Telephone | 757-469-0406
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | MRS. ANGELA MOORE
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Credential |
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Telephone | 757-469-0406
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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 | VA
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