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NPI Code Detail

MEDICARE: STASKEY ENTERPRISES LLC

MEDICARE: STASKEY ENTERPRISES LLC
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1285071084
Entity Type Code : Organization
Provider Name (Legal Business Name) : STASKEY ENTERPRISES LLC
Provider Business Mailing Address
First Line : 3650 CHIMNEY CREEK DR
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23462-6819
Country : US
Telephone Number : 757-323-2103
Fax Number : 757-340-2537
Provider Business Practice Location Address
First Line : 3650 CHIMNEY CREEK DR
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23462-6819
Country : US
Telephone Number : 757-323-2103
Fax Number : 757-340-2537
Authorized Official
Title or Position : OWNER
Name : LITA STASKEY
Credential : MBA, CEAP
Telephone Number : 757-323-2103
Provider Enumeration Date : 06/03/2013
Last Update Date : 06/03/2013

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Directions to “STASKEY ENTERPRISES LLC ” Practice Location

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