Provider Demographics
NPI:1477037885
Name:THE FAYE BONNICK CENTER FOR HEALING AND RECOVERY
Entity Type:Organization
Organization Name:THE FAYE BONNICK CENTER FOR HEALING AND RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANCIS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:757-405-7506
Mailing Address - Street 1:333 KELLAM RD STE 1
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-2746
Mailing Address - Country:US
Mailing Address - Phone:757-405-7506
Mailing Address - Fax:757-499-1696
Practice Address - Street 1:333 KELLAM RD STE 1
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-2746
Practice Address - Country:US
Practice Address - Phone:757-405-7506
Practice Address - Fax:757-499-1696
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-20
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)