Provider Demographics
NPI:1336442060
Name:BSV HEALTH AND WELLNESS CENTER LLC
Entity Type:Organization
Organization Name:BSV HEALTH AND WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLEY
Authorized Official - Middle Name:M
Authorized Official - Last Name:ALLSBROOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-420-2512
Mailing Address - Street 1:6401 AUBURN DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-3601
Mailing Address - Country:US
Mailing Address - Phone:757-420-2512
Mailing Address - Fax:757-424-0567
Practice Address - Street 1:6401 AUBURN DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-3601
Practice Address - Country:US
Practice Address - Phone:757-420-2512
Practice Address - Fax:757-424-0567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-20
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care