Provider Demographics
NPI:1982859708
Name:NIEGHBOR TO FAMILY
Entity Type:Organization
Organization Name:NIEGHBOR TO FAMILY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LSW
Authorized Official - Phone:757-213-1580
Mailing Address - Street 1:1300 DIAMOND SPRINGS RD
Mailing Address - Street 2:SUITE 502
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-3645
Mailing Address - Country:US
Mailing Address - Phone:757-213-1580
Mailing Address - Fax:757-213-1599
Practice Address - Street 1:1300 DIAMOND SPRINGS RD
Practice Address - Street 2:SUITE 502
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-3645
Practice Address - Country:US
Practice Address - Phone:757-213-1580
Practice Address - Fax:757-213-1599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-20
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA897251S00000X
253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0102900823Medicaid