Provider Demographics
NPI:1760090716
Name:AIM OUTPATIENT LLC
Entity Type:Organization
Organization Name:AIM OUTPATIENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HERMIONE
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-627-1530
Mailing Address - Street 1:870 N MILITARY HWY STE 310
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-3647
Mailing Address - Country:US
Mailing Address - Phone:757-627-1530
Mailing Address - Fax:
Practice Address - Street 1:870 N MILITARY HWY STE 310
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3647
Practice Address - Country:US
Practice Address - Phone:757-627-1530
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-15
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health