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Organization
EDWARDS PROVISION SUPPORT SERVICES
Active
Organization
EDWARDS PROVISION SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE THORNTON (OWNER)
(757) 286-4212
Entity
Organization
Contact information
Practice address
424 INVESTORS PLACE STE 104 PMB 1056, VIRGINIA BEACH, VA 23452
(757) 286-4212
(757) 866-5162
Mailing address
424 INVESTORS PLACE STE 104 PMB 1056, VIRGINIA BEACH, VA 23452
(757) 286-4212
(757) 866-5162
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
NULL
171M00000X
Case Manager/Care Coordinator
Primary
—
—
251B00000X
Case Management Agency
—
NULL
Other
Enumeration date
01/20/2023
Last updated
12/30/2025
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