Provider Demographics
NPI:1518473727
Name:SIMS SUPPORTIVE SERVICES, LLC.
Entity Type:Organization
Organization Name:SIMS SUPPORTIVE SERVICES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-363-6329
Mailing Address - Street 1:8026 RUTLAND VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-2971
Mailing Address - Country:US
Mailing Address - Phone:804-363-6329
Mailing Address - Fax:
Practice Address - Street 1:8026 RUTLAND VILLAGE DR
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-2971
Practice Address - Country:US
Practice Address - Phone:804-363-6329
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-26
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA286003001251S00000X
VA0701006199251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health