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General NPI Number Information
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NPI Number | 1831572304
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Entity Type | Organization
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Legal Business Name | SUPPORTING ARMS CONTINUING CARE, LLC
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Dates
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Enumeration Date | 07/02/2015
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Last Update Date | 03/02/2016
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Provider Practice Location Address
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Address Line | 540 E CONSTANCE RD SUITE B
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City | SUFFOLK
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State | VA
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Zip | 23434-3004
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Country | US
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Telephone | 757-539-0407
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Fax | 757-539-8394
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Provider Business Mailing Address
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Address Line | 540 E CONSTANCE RD SUITE B
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City | SUFFOLK
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State | VA
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Zip | 23434-3004
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Country | US
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Telephone | 757-539-0407
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Fax | 757-539-8394
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Authorized Official
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Title or Position | CEO/EXECUTIVE DIRECTOR
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Name | DR. SONYA LEVETTE LEE
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Credential | ED.D, CSAS
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Telephone | 757-572-1517
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | 0710102165
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 0710102165
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | 2242
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License Number State | VA
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