MEDICARE: JTRR SUPPORT SEVICES

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
1	320800000X	Mental Illness Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1598609315
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JTRR SUPPORT SEVICES

Provider Business Mailing Address
First Line	:	207 W 36TH ST
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23504-1306
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	207 W 36TH ST
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23504-1306
Country	:	US
Telephone Number	:	757-904-1541
Fax Number	:

Authorized Official
Title or Position	:	LMHP-R
Name	:	TAMIKA HAYES
Credential	:
Telephone Number	:	757-805-2882

Provider Enumeration Date	:	04/14/2026
Last Update Date	:	04/14/2026

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Directions to “JTRR SUPPORT SEVICES ” Practice Location

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