Provider Demographics
NPI:1841754272
Name:ESSENTIAL PIECE LIFE ENRICHMENT SERVICES
Entity Type:Organization
Organization Name:ESSENTIAL PIECE LIFE ENRICHMENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARQUETTA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:COURTS-NORTON
Authorized Official - Suffix:
Authorized Official - Credentials:QMHP
Authorized Official - Phone:757-508-3221
Mailing Address - Street 1:237 KOVE DR
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23669-2155
Mailing Address - Country:US
Mailing Address - Phone:757-508-3221
Mailing Address - Fax:
Practice Address - Street 1:12 SALTERS CREEK RD STE 200
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23661-2453
Practice Address - Country:US
Practice Address - Phone:757-750-3505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-30
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty