Provider Demographics
NPI:1326364696
Name:PURVIS NETWORK INC.
Entity Type:Organization
Organization Name:PURVIS NETWORK INC.
Other - Org Name:BELL'S HAVEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CHANELL
Authorized Official - Middle Name:L
Authorized Official - Last Name:PURVIS
Authorized Official - Suffix:
Authorized Official - Credentials:QMHP, CSAC
Authorized Official - Phone:757-408-6133
Mailing Address - Street 1:2829 MAPLETON AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23504-3721
Mailing Address - Country:US
Mailing Address - Phone:757-408-6133
Mailing Address - Fax:
Practice Address - Street 1:2829 MAPLETON AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23504-3721
Practice Address - Country:US
Practice Address - Phone:757-408-6133
Practice Address - Fax:757-545-6109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-12
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA950320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness