Organization
MADE WHOLE THERAPEUTIC SERVICES LLC
Active
Organization
MADE WHOLE THERAPEUTIC SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATAYA TAYLOR-MAKELL (OWNER)
(804) 490-3365
Entity
Organization
Contact information
Practice address
732 THIMBLE SHOALS BLVD STE 304, NEWPORT NEWS, VA 23606-4258
(804) 490-3365
Mailing address
311 LIGHTHOUSE WAY, CARROLLTON, VA 23314-3364
(804) 490-3365
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/09/2026
Last updated
04/09/2026
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