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General NPI Number Information
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NPI Number | 1831289669
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Entity Type | Organization
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Legal Business Name | FAMILY REDIRECTION INSTITUTE, INC.
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 06/16/2011
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Provider Practice Location Address
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Address Line | 5062 PORTSMOUTH BOULEVARD
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City | CHESAPEAKE
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State | VA
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Zip | 23321-1426
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Country | US
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Telephone | 757-398-0200
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Fax | 757-398-0057
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Provider Business Mailing Address
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Address Line | 5062 PORTSMOUTH BOULEVARD
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City | CHESAPEAKE
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State | VA
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Zip | 23321-1426
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Country | US
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Telephone | 757-398-0200
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Fax | 757-398-0057
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. JEFFREY L MOORE
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Credential |
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Telephone | 757-398-0200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 333-05-001
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License Number State | VA
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