=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851723969
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AIM FAMILY SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/31/2013
-----------------------------------------------------
Last Update Date | 07/31/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 221 MARKET ST SUITE 554
-----------------------------------------------------
City | VIRGINIA BEACH
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23462-3296
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-291-5134
-----------------------------------------------------
Fax | 757-490-8760
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 221 MARKET ST SUITE 554
-----------------------------------------------------
City | VIRGINIA BEACH
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23462-3296
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-291-5134
-----------------------------------------------------
Fax | 757-490-8760
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | DEBORAH HAMILTON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 757-291-5134
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number | 2050
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------