Provider Demographics
NPI:1619720166
Name:TRIBE HEALTHCARE
Entity Type:Organization
Organization Name:TRIBE HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:ASONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-738-7423
Mailing Address - Street 1:521 N ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23220-3903
Mailing Address - Country:US
Mailing Address - Phone:804-738-7423
Mailing Address - Fax:804-738-8383
Practice Address - Street 1:521 N ADAMS ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23220-3903
Practice Address - Country:US
Practice Address - Phone:804-738-7423
Practice Address - Fax:804-738-8383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health