Organization
ELITE THERAPEUTIC SERVICES, LLC
Active
Other names
Mary's Manger
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KIMBERLY M HAYWOOD (OWNER)
(757) 735-4565
Entity
Organization
Contact information
Practice address
2401 CREPE MYRTLE LN, CHESAPEAKE, VA 23325-4644
(757) 735-4565
Mailing address
2401 CREPE MYRTLE LN, CHESAPEAKE, VA 23325-4644
(757) 735-4565
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/24/2013
Last updated
08/24/2013
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