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Organization
PENINSULA CHILD & FAMILY SERVICES LLC
Active
Organization
PENINSULA CHILD & FAMILY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH FARRELL (OWNER)
(707) 478-6120
Entity
Organization
Contact information
Practice address
4410 CLAIBORNE SQ E STE 334, HAMPTON, VA 23666-2074
(757) 977-0889
(757) 977-0895
Mailing address
4410 CLAIBORNE SQ E STE 334, HAMPTON, VA 23666-2074
(757) 977-0889
(757) 977-0895
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904009684
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1649717158
SOLE PROPRIETOR NUMBER
VA
Enumeration date
04/17/2018
Last updated
04/17/2018
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