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General NPI Number Information
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NPI Number | 1861974966
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Entity Type | Organization
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Legal Business Name | UNITED COMMUNITY SOLUTIONS, LLC
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Dates
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Enumeration Date | 09/05/2018
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Last Update Date | 12/12/2023
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Provider Practice Location Address
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Address Line | 115 BRUTON CT STE C
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City | CHESAPEAKE
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State | VA
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Zip | 23322-4377
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Country | US
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Telephone | 757-410-2644
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Fax | 757-282-5802
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Provider Business Mailing Address
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Address Line | 115 BRUTON CT STE C
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City | CHESAPEAKE
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State | VA
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Zip | 23322-4377
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Country | US
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Telephone | 757-410-2644
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Fax | 757-819-6990
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Authorized Official
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Title or Position | CEO
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Name | KIMBERLY JACKSON
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Credential | QMHP-C
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Telephone | 434-229-0172
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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 | 3254
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License Number State | VA
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