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Organization

UNIQUELY DIFFERENT THERAPEUTIC SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SABRINA GORDON (OWNER)
(757) 777-5240
Entity
Organization

Contact information

Practice address
533 REBEL RD, CHESAPEAKE, VA 23322-3523
(757) 777-5240
Mailing address
533 REBEL RD, CHESAPEAKE, VA 23322-3523
(757) 777-5240

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
251B00000X
Case Management Agency
251S00000X
Community/Behavioral Health Agency
253Z00000X
In Home Supportive Care Agency

Other

Enumeration date
07/19/2023
Last updated
07/19/2023
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