MEDICARE: NEXUS COMMUNITY SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
2	261QM0850X	Adult Mental Health Clinic/Center
3	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1164136776
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEXUS COMMUNITY SERVICES

Provider Business Mailing Address
First Line	:	11300 IRON BRIDGE RD STE C
Second Line	:
City	:	CHESTER
State	:	VA
Zip	:	23831-1428
Country	:	US
Telephone Number	:	757-575-3606
Fax Number	:	804-362-9003

Provider Business Practice Location Address
First Line	:	11300 IRON BRIDGE RD STE C
Second Line	:
City	:	CHESTER
State	:	VA
Zip	:	23831-1428
Country	:	US
Telephone Number	:	757-575-3606
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. DAVID HUGH FITZGERALD JR.
Credential	:
Telephone Number	:	267-634-1784

Provider Enumeration Date	:	01/09/2023
Last Update Date	:	05/06/2023

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Directions to “NEXUS COMMUNITY SERVICES ” Practice Location

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