Together Lives Change

NPI 1255633582 - Community/Behavioral Health - 251S00000X

NPI Details
NPI 1255633582
Enumeration Date 11/18/2010
Last Updated 06/29/2012
Entity Type Healthcare Provider
Active Over 6 years ago
Authorized Information
Name TIFFANY NICOLE TIFFANY
Position CHIEF EXECUTIVE OFFICER
Phone (757) 325-8452
Fax (757) 224-1156
Practice Location
2115 EXECUTIVE DR
BUILDING 10-D
HAMPTON VA, 23666-2499, US
Phone (757) 325-8452
Fax (757) 224-1156
Business Location
2115 EXECUTIVE DR
BUILDING 10-D
HAMPTON VA, 23666-2499, US
Phone (757) 325-8452
Fax (757) 224-1156
Toxanomy
Taxonomy Code 251S00000X
License State Virginia
License Number 1701
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According to our database, Together Lives Change NPI is 1255633582, taxonomy code is 251S00000X and license number is 1701, license state is located at Virginia. Together Lives Change physically located at 2115 Executive Dr, Hampton VA, 23666-2499. NPI Number 1033115704 has the healthcare provider type.

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1255633582 NPI number is provided on an as is basis without warranty of any kind. 1255633582 is maintained by the National Plan & Provider Enumeration System. The contents of Together Lives Change are for informational purposes only.