Organization
REFUEL LIFE TRAUMA CENTER, LLC
Active
Organization
REFUEL LIFE TRAUMA CENTER, LLC
Active
Other names
Refuel Families, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICE DANIELLE MURPHY LPC, NCC (LICENSED PROFESSIONAL COUNSELOR)
(757) 453-4110
Entity
Organization
Contact information
Practice address
100 SABAL PALM LN APT 303, CHESAPEAKE, VA 23320-1734
(757) 288-8794
Mailing address
100 SABAL PALM LN APT 303, CHESAPEAKE, VA 23320-1734
(757) 288-8794
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1629719786
INDIVIDUAL NNPI TYPE 1
VA
Enumeration date
11/15/2023
Last updated
11/15/2023
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