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General NPI Number Information
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NPI Number | 1841514999
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Entity Type | Organization
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Legal Business Name | ANOTHER LEVEL YOUTH & FAMILY SERVICES, LLC
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Dates
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Enumeration Date | 03/18/2010
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Last Update Date | 12/26/2014
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Provider Practice Location Address
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Address Line | 11028 WARWICK BOULEVARD
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City | NEWPORT NEWS
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State | VA
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Zip | 23601
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Country | US
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Telephone | 757-419-3329
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Fax | 757-257-4143
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Provider Business Mailing Address
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Address Line | 11028 WARWICK BOULEVARD
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City | NEWPORT NEWS
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State | VA
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Zip | 23601
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Country | US
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Telephone | 757-419-3329
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Fax | 757-257-4143
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MR. RONNIE DAVIS JR.
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Credential |
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Telephone | 757-419-3329
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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 | 1402-05-001
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License Number State | VA
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