EASTERN GROVE SUPPORT LLC NPI 1700694320

NPI Information

  • NPI: 1700694320
  • Provider Name: EASTERN GROVE SUPPORT LLC
  • Classification: Clinic/Center - 261QM0801X
  • Specialization: Mental Health (Including Community Mental Health Center)
  • Entity Type: Organization
  • Address: 355 CRAWFORD ST STE 600B
    PORTSMOUTH, VA
    ZIP 23704
  • Phone: (833) 774-9633

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NPI Details

EASTERN GROVE SUPPORT LLC is a mental health (including community mental health center) clinic center in Portsmouth, VA. EASTERN GROVE SUPPORT LLC NPI is 1700694320. The provider is registered as an organization entity type.

The provider's business location address is:

355 CRAWFORD ST STE 600B
PORTSMOUTH, VA
ZIP 23704-823
Phone: (833) 774-9633

The provider's authorized official is Keenen Mapp .
The authorized official title is Director and has the following contact phone number (833) 774-9633.

The enumeration date for this NPI number is 12/28/2024 and was last updated on 1/2/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1251S00000XCommunity/Behavioral HealthNo
2261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)Yes
3261QM0850XClinic/CenterAdult Mental HealthNo
4261QM0855XClinic/CenterAdolescent and Children Mental HealthNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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