MEDICARE: HOMING REACH 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
1	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1922815877
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOMING REACH LLC

Provider Business Mailing Address
First Line	:	207 WYNN ST
Second Line	:
City	:	PORTSMOUTH
State	:	VA
Zip	:	23701-3141
Country	:	US
Telephone Number	:	757-749-2125
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 GOLDEN OAK CT STE 150
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23452-8512
Country	:	US
Telephone Number	:	757-749-2125
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MONTY MARSHALL
Credential	:
Telephone Number	:	757-749-2125

Provider Enumeration Date	:	12/13/2024
Last Update Date	:	12/13/2024

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Directions to “HOMING REACH LLC ” Practice Location

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