Provider Demographics
NPI:1982367801
Name:DESTINED FOR BRIGHTER FUTURES FOUNDATION LLC
Entity Type:Organization
Organization Name:DESTINED FOR BRIGHTER FUTURES FOUNDATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:DAVIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:FALTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-239-9125
Mailing Address - Street 1:900 COMMONWEALTH PL STE 225
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-4517
Mailing Address - Country:US
Mailing Address - Phone:757-239-9125
Mailing Address - Fax:
Practice Address - Street 1:900 COMMONWEALTH PL STE 225
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-4517
Practice Address - Country:US
Practice Address - Phone:757-239-9125
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-18
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty