Provider Demographics
NPI:1659423200
Name:THE BARRY ROBINSON CENTER
Entity Type:Organization
Organization Name:THE BARRY ROBINSON CENTER
Other - Org Name:HOMEBASE PROGRAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HOMEBASE PROGRAM DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:BRADLEY
Authorized Official - Last Name:FINK
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:757-455-6187
Mailing Address - Street 1:443 KEMPSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-4727
Mailing Address - Country:US
Mailing Address - Phone:757-455-6207
Mailing Address - Fax:757-466-0767
Practice Address - Street 1:443 KEMPSVILLE RD
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-4727
Practice Address - Country:US
Practice Address - Phone:757-455-6207
Practice Address - Fax:757-466-0767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA185251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA185-05-001OtherTRIENNIAL
VA04-74OtherHOME CARE LICENSE NUMBER