Provider Demographics
NPI:1235613357
Name:EXCEPTIONAL PEOPLE PLUS LLC
Entity Type:Organization
Organization Name:EXCEPTIONAL PEOPLE PLUS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTIOR/CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BLOCKER-REEVES
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:757-405-4425
Mailing Address - Street 1:5508 GOSLING CT
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-7297
Mailing Address - Country:US
Mailing Address - Phone:757-405-4425
Mailing Address - Fax:
Practice Address - Street 1:1761 CHURCH ST STE 100
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23504-2313
Practice Address - Country:US
Practice Address - Phone:757-405-4425
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-25
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2867OtherDEPARTMENT OF BEHAVIORAL HEALTH & DEVELOPMENTAL SERVICES