Provider Demographics
NPI:1881142172
Name:MARRIAGE MATES
Entity type:Organization
Organization Name:MARRIAGE MATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:LYNNE
Authorized Official - Middle Name:
Authorized Official - Last Name:SKYE-ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-464-5132
Mailing Address - Street 1:9962 BROOK RD
Mailing Address - Street 2:#620
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-6501
Mailing Address - Country:US
Mailing Address - Phone:804-464-5132
Mailing Address - Fax:
Practice Address - Street 1:15720 BRIXHAM HILL AVE
Practice Address - Street 2:SUITE 30028277
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-4651
Practice Address - Country:US
Practice Address - Phone:704-464-5132
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-14
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care