Organization
BANNER OF SUPPORT LLC
Active
Other names
Banner of Support
Organization subpart
No
Provider details
NPI number
Authorized official
GAIL MARIE JEFFREY (OWNER)
(757) 251-0655
Entity
Organization
Contact information
Practice address
3411 SUNNYSIDE DR, HAMPTON, VA 23666-3706
(757) 251-0655
Mailing address
PO BOX 5435, NEWPORT NEWS, VA 23605-0435
(757) 251-0655
(757) 325-6685
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
04/17/2024
Last updated
05/15/2024
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