Organization
BROOKSHAVEN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KRISTAL B BROOKS LCSW (PROGRAM MANAGER)
(757) 822-3835
Entity
Organization
Contact information
Practice address
1503 LASALLE AVE, PORTSMOUTH, VA 23704-4639
(757) 822-3835
(888) 830-5926
Mailing address
1503 LASALLE AVE UNIT C, PORTSMOUTH, VA 23704-4639
(757) 822-3835
(888) 830-5926
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
—
Other
Enumeration date
07/02/2025
Last updated
07/02/2025
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