Provider Demographics
NPI:1841982584
Name:PAYTONS PLACE LLC
Entity type:Organization
Organization Name:PAYTONS PLACE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARISSE
Authorized Official - Middle Name:STEPHANIE
Authorized Official - Last Name:MARROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-358-4381
Mailing Address - Street 1:309 LEES MILL DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23608-5027
Mailing Address - Country:US
Mailing Address - Phone:757-358-4381
Mailing Address - Fax:
Practice Address - Street 1:309 LEES MILL DR
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23608-5027
Practice Address - Country:US
Practice Address - Phone:757-358-4381
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral Health