Provider Demographics
NPI:1457727158
Name:BFS TREEHOUSE
Entity type:Organization
Organization Name:BFS TREEHOUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COO
Authorized Official - Prefix:
Authorized Official - First Name:DERRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:MELVIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-227-4644
Mailing Address - Street 1:5606A VIRGINIA BEACH BLVD
Mailing Address - Street 2:SUITE 101 & 102
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-5684
Mailing Address - Country:US
Mailing Address - Phone:757-227-4644
Mailing Address - Fax:
Practice Address - Street 1:522 S INDEPENDENCE BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-1149
Practice Address - Country:US
Practice Address - Phone:757-227-4644
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BENEVOLENT FAMILY SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-08-17
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2017261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health