Provider Demographics
NPI:1457821241
Name:TEAM LLC
Entity Type:Organization
Organization Name:TEAM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXCEUTIVE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TERRA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:804-591-8621
Mailing Address - Street 1:701 E FRANKLIN ST STE 710
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23219-2511
Mailing Address - Country:US
Mailing Address - Phone:804-591-8621
Mailing Address - Fax:
Practice Address - Street 1:701 E FRANKLIN ST STE 710
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23219-2511
Practice Address - Country:US
Practice Address - Phone:804-591-8621
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-05
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)