Organization
EVOLVE THERAPEUTIC COUNSELING SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTOR M MOODY (VICE PRESIDENT)
(757) 224-7986
Entity
Organization
Contact information
Practice address
2021B CUNNINGHAM DR, SUITE 2, HAMPTON, VA 23666-3326
(757) 224-7986
(757) 224-8321
Mailing address
PO BOX 7429, HAMPTON, VA 23666-0429
(757) 224-7986
(757) 224-8321
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
VA
Other
Enumeration date
01/15/2008
Last updated
01/15/2008
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