Western Tidewater Community Services Board

LBN: Western Tidewater Community Mental
Western Tidewater Community Services Board is an health care organization with primary practice located at 7025 Harbour View Blvd Ste 119 , Suffolk VA 23435-2762. The organization recently has 7 registered licenses in different health care specialties including Agencies / Case Management, Agencies / Day Training, Developmentally Disabled Services, Agencies / In Home Supportive Care, Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), Ambulatory Health Care Facilities / Adult Mental Health, Ambulatory Health Care Facilities / Adolescent and Children Mental Health, Transportation Services / Non-emergency Medical Transport (VAN). Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) is the primary health care specialty. Western Tidewater Community Mental can be contacted via phone (757) 966-2805, or through Young, Marion via phone (757) 687-9087.

Contact Information

Primary practice address
7025 Harbour View Blvd Ste 119 Suffolk VA 23435-2762
Phone: (757) 966-2805
Fax: (757) 673-2586
Website:
Map and Directions
Authorized official contact:
Name: Young, Marion
Phone: (757) 687-9087

Health care specialties

SpecialtyCodeLicense #State
Agencies / Case Management 251B00000X 084-16-001 Virginia
Agencies / Day Training, Developmentally Disabled Services 251C00000X
Agencies / In Home Supportive Care 253Z00000X
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X 084-03-002 Virginia
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X
Ambulatory Health Care Facilities / Adult Mental Health 261QM0850X 084-03-002 Virginia
Ambulatory Health Care Facilities / Adolescent and Children Mental Health 261QM0855X 084-02-029 Virginia
Transportation Services / Non-emergency Medical Transport (VAN) 343900000X Virginia

Profile Details

NPI number 1689615296
LBN Legal business name Western Tidewater Community Mental
DBA Doing business as Western Tidewater Community Services Board
Authorized official Young, Marion
Entity Organization
Organization subpart 1 No
Enumeration date Jun 8th, 2006
Last updated May 17th, 2023 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1689615296 NPPES
Virginia Other 270369 ANTHEM GROUP NUMBER
Virginia MEDICAID 004945310 ANTHEM GROUP NUMBER
Virginia MEDICAID 1689615296 ANTHEM GROUP NUMBER

Popular Providers