Provider Demographics
NPI:1356767040
Name:PSALMS ASSISTIVE SUPPORT SERVICES LLC
Entity type:Organization
Organization Name:PSALMS ASSISTIVE SUPPORT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LATASHA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:HOLLOWAY
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:757-348-0456
Mailing Address - Street 1:509 W 35TH ST
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23508-3101
Mailing Address - Country:US
Mailing Address - Phone:757-348-0456
Mailing Address - Fax:
Practice Address - Street 1:509 W 35TH ST
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23508-3101
Practice Address - Country:US
Practice Address - Phone:757-348-0456
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-05
Last Update Date:2014-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities