Provider Demographics
NPI:1578242053
Name:SHAPING YOUR FUTURE HOMES LLC
Entity Type:Organization
Organization Name:SHAPING YOUR FUTURE HOMES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TRISHA
Authorized Official - Middle Name:NARDIA
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:757-528-2850
Mailing Address - Street 1:1534 BATEAU LNDG
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23321-6603
Mailing Address - Country:US
Mailing Address - Phone:757-528-2850
Mailing Address - Fax:757-432-3159
Practice Address - Street 1:1312 WIRT AVE
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23704-6950
Practice Address - Country:US
Practice Address - Phone:757-528-2850
Practice Address - Fax:757-432-3159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-13
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health