Organization
CITY OF CHESAPEAKE
Active
Other names
Chesapeake Integrated Behavioral Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH SCISLOWICZ LPC (EXECUTIVE DIRECTOR)
(757) 819-6214
Entity
Organization
Contact information
Practice address
1829 ROKEBY AVE, CHESAPEAKE, VA 23320-2261
(757) 282-6639
(757) 282-6814
Mailing address
224 GREAT BRIDGE BLVD, CHESAPEAKE, VA 23320-3904
(757) 547-9334
(757) 819-6292
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
141010005
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40-G062
PROVIDER NUMBER
VA
Enumeration date
07/21/2014
Last updated
07/21/2014
Update your record
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