Organization
SEL
Active
Other names
Inclusicare Supportive Services
Organization subpart
No
Provider details
NPI number
Authorized official
MISS TIERRA SHANTE MULLEN (CEO)
(757) 837-6060
Entity
Organization
Contact information
Practice address
500 E MAIN ST, NORFOLK, VA 23510-2205
(757) 837-6060
Mailing address
500 E MAIN ST, NORFOLK, VA 23510-2205
(757) 837-6060
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/23/2025
Last updated
07/23/2025
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