Provider Demographics
NPI:1184910978
Name:UNISON MENTAL HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:UNISON MENTAL HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:PATRICE
Authorized Official - Middle Name:
Authorized Official - Last Name:MATTHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-469-0332
Mailing Address - Street 1:6060 JEFFERSON AVE
Mailing Address - Street 2:SUITE 9003
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23605-3014
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6060 JEFFERSON AVE
Practice Address - Street 2:SUITE 9003
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23605-3014
Practice Address - Country:US
Practice Address - Phone:757-706-3382
Practice Address - Fax:757-706-3383
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DESTINYS HOUSE RESIDENTIAL SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-06-21
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA990251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health