=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932855574
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COMMITMENT TO EXCELLENCE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/22/2022
-----------------------------------------------------
Last Update Date | 02/22/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 900 GRANBY ST
-----------------------------------------------------
City | NORFOLK
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23510-2503
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-375-7554
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1003 GALT ST
-----------------------------------------------------
City | NORFOLK
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23504-2527
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-375-7554
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | SERAPHINE NYUYDINE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 757-375-7554
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------