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General NPI Number Information
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NPI Number | 1891930541
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Entity Type | Organization
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Legal Business Name | G.E.S.U.S. BALL, INC.
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Dates
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Enumeration Date | 12/10/2008
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Last Update Date | 12/10/2008
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Provider Practice Location Address
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Address Line | 26 LUCAS CREEK RD
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City | NEWPORT NEWS
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State | VA
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Zip | 23602-7486
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Country | US
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Telephone | 757-327-9774
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Fax | 757-989-0935
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Provider Business Mailing Address
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Address Line | PO BOX 12164
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City | NEWPORT NEWS
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State | VA
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Zip | 23612-2164
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Country | US
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Telephone | 757-989-0935
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Fax | 757-989-0935
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. W LAMONT STROTHERS
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Credential |
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Telephone | 757-989-0935
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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