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NPI Code Detail

MEDICARE: CAMPBELL HOUSE INC

MEDICARE: CAMPBELL HOUSE INC
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
1320800000XMental Illness Community Based Residential Treatment Facility861-14-001VA

General Provider Information

NPI Number : 1811023997
Entity Type Code : Organization
Provider Name (Legal Business Name) : CAMPBELL HOUSE INC
Provider Business Mailing Address
First Line : 5328 HALTER LN
Second Line :
City : NORFOLK
State : VA
Zip : 23502-4435
Country : US
Telephone Number : 757-237-6962
Fax Number : 757-858-0881
Provider Business Practice Location Address
First Line : 2531 VINCENT AVE
Second Line :
City : NORFOLK
State : VA
Zip : 23509-2339
Country : US
Telephone Number : 757-858-0881
Fax Number : 757-858-0881
Authorized Official
Title or Position : CEO
Name : MRS. JACQUELINE CAMPBELL
Credential :
Telephone Number : 757-237-6962
Provider Enumeration Date : 02/26/2007
Last Update Date : 08/22/2020

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Directions to “CAMPBELL HOUSE INC ” Practice Location

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