MEDICARE: CATHOLIC CHARITIES OF EASTERN VIRGINIA 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
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1962432294
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CATHOLIC CHARITIES OF EASTERN VIRGINIA INC

Provider Business Mailing Address
First Line	:	5361A VIRGINIA BEACH BLVD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-1897
Country	:	US
Telephone Number	:	757-456-2366
Fax Number	:	757-456-2367

Provider Business Practice Location Address
First Line	:	4855 PRINCESS ANNE RD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-4446
Country	:	US
Telephone Number	:	757-467-7707
Fax Number	:	757-495-3206

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. DOMINICK R CALGI
Credential	:
Telephone Number	:	757-456-2366

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	04/25/2009

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