Organization
PHOENIX ASPIRATION SYSTEM OF CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH M. HECTOR (ADMINISTRATOR)
(757) 393-5850
Entity
Organization
Contact information
Practice address
2710 ELM AVE, PORTSMOUTH, VA 23704-7013
(757) 393-5850
(757) 393-5853
Mailing address
2710 ELM AVE, PORTSMOUTH, VA 23704-7013
(757) 393-5850
(757) 393-5853
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
731-01-001
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0101495098
—
VA
Enumeration date
09/23/2008
Last updated
09/23/2008
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