NPI 1194839704

Our Summer Place,llc

Organisation Point of Service Portsmouth, VA

Practice location

Address: 3511 Blaine St, Portsmouth, VA 23703-3115
Phone: (757) 483-4880
Fax: (757) 483-1578
Mailing address: PO Box 3221, Portsmouth, VA 23701-0221

Authorised official

Name: Zatera a Spencer
Title: Owner/Administrator
Phone: (757) 966-9978

Registered specialties

Point of Service Primary

Managed Care Organizations Taxonomy 305S00000X Licence 558 (VA)

Other Point of Service providers in Virginia →

Registry record

NPI: 1194839704
Entity type: Organization
NPI issued: 19 Aug 2006
Record last updated: 23 Jun 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.