Provider Demographics
NPI:1497040794
Name:SPECIAL NEEDS ASSISTANCE PROGRAM
Entity Type:Organization
Organization Name:SPECIAL NEEDS ASSISTANCE PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAM
Authorized Official - Middle Name:
Authorized Official - Last Name:FLOYD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-389-2054
Mailing Address - Street 1:3868 CHATHAM CIRCLE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23513
Mailing Address - Country:US
Mailing Address - Phone:757-389-2054
Mailing Address - Fax:
Practice Address - Street 1:3868 CHATHAM CIR
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23513-3445
Practice Address - Country:US
Practice Address - Phone:757-389-2054
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-14
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management