MEDICARE: A DOOR TO OPPORTUNITY 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	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1952265118
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A DOOR TO OPPORTUNITY LLC

Provider Business Mailing Address
First Line	:	900 COMMONWEALTH PL STE 215
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23464-4529
Country	:	US
Telephone Number	:	757-288-1360
Fax Number	:	866-679-1446

Provider Business Practice Location Address
First Line	:	900 COMMONWEALTH PL STE 215
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23464-4529
Country	:	US
Telephone Number	:	757-288-1360
Fax Number	:	866-679-1446

Authorized Official
Title or Position	:	CEO
Name	:	GWENDOLYN REED
Credential	:
Telephone Number	:	757-288-1360

Provider Enumeration Date	:	12/12/2025
Last Update Date	:	12/12/2025

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