Organization
SHAPING YOUR FUTURE HOMES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRISHA NARDIA PARKER PMHNP (CEO)
(757) 528-2850
Entity
Organization
Contact information
Practice address
1312 WIRT AVE, PORTSMOUTH, VA 23704-6950
(757) 528-2850
(757) 432-3159
Mailing address
4300 PORTSMOUTH BLVD UNIT 9183, CHESAPEAKE, VA 23321-0607
(757) 528-2850
(757) 432-3159
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
323P00000X
Psychiatric Residential Treatment Facility
—
—
Other
Enumeration date
07/13/2023
Last updated
09/06/2024
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