Organization
JAMES BENTLEY TREATMENT PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SANDRA PINNOCK (PRESIDENT)
(757) 399-4742
Entity
Organization
Contact information
Practice address
1520 HIGH ST, PORTSMOUTH, VA 23704-3210
(757) 399-4742
Mailing address
1520 HIGH ST, PORTSMOUTH, VA 23704-3210
(757) 399-4742
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
78203001
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
78203001
—
VA
Enumeration date
11/04/2011
Last updated
11/04/2011
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