Western Tidewater Community Mental is a Non-emergency Medical Transport (VAN) based in Suffolk, VA. Western Tidewater Community Mental practices in Suffolk, VA. The NPI Number for Western Tidewater Community Mental is 1689615296 and holds a License No. 084-16-001 (Virginia).
The current practice location address for Western Tidewater Community Mental is 7025 Harbour View Blvd Ste 119, Suffolk, VA and can be reached out via phone at 757-966-2805 and via fax at 757-673-2586.
Location: 7025 Harbour View Blvd Ste 119, Suffolk, VA, 23435-2762
Provider Profile Details
NPI Number
1689615296
Provider Name
Western Tidewater Community Mental
Credential
Provider Entity Type
Organization
Address
7025 Harbour View Blvd Ste 119, Suffolk, VA, 23435-2762
Phone Number
757-966-2805
Fax Number
757-673-2586
Provider Enumeration Date
06/08/2006
Last Update Date
03/12/2024
Provider's Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 270369 | 01 | VA | ANTHEM GROUP NUMBER |
| 004945310 | 05 | VA | |
| 1689615296 | 05 | VA |
Provider Business Practice Location Address Details
Address
7025 Harbour View Blvd Ste 119
City
State
Zip
23435-2762
Phone Number
757-966-2805
Fax Number
757-673-2586
Provider Business Mailing Address Details
Address
7025 Harbour View Blvd Ste 119
City
State
Zip
23435-2762
Phone Number
757-966-2805
Fax Number
757-673-2586
Provider's Taxonomy Details 1
Type
Agencies
Classification
Case Management
Speciality
-
Taxonomy
License No.
084-02-029 (Virginia)
Definition
An organization that is responsible for providing case management services. The agency provides services which assist an individual in gaining access to needed medical, social, educational, and/or other services. Case management services may be used to locate, coordinate, and monitor necessary appropriate services. It may be used to encourage the use of cost-effective medical care by referrals to appropriate providers and to discourage over utilization of costly services. Case management may also serve to provide necessary coordination of non-medical services such as vocational rehabilitation, education, employment, when the services provided enable the individual to function at the highest level.
Provider's Taxonomy Details 2
Type
Agencies
Classification
Day Training, Developmentally Disabled Services
Speciality
-
Taxonomy
License No.
084-03-002 (Virginia)
Definition
These agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning.
Provider's Taxonomy Details 3
Type
Agencies
Classification
In Home Supportive Care
Speciality
-
Taxonomy
License No.
()
Definition
An In Home Supportive Care Agency provides services in the patient's home with the goal of enabling the patient to remain at home. The services provided may include personal care services such as hands-on assistance with activities of daily living (ADLs), e.g., eating, bathing, dressing, and bladder and bowel requirements; homemaker services and instrumental activities of daily living (IADLs), e.g., taking medications, shopping for groceries, laundry, housekeeping, and companionship; and/or supervision or cuing so that a person can perform tasks themselves.
Provider's Taxonomy Details 4
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Mental Health (Including Community Mental Health Center)
Taxonomy
License No.
084-03-002 (Virginia)
Definition
Definition to come...
Provider's Taxonomy Details 5
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adult Mental Health
Taxonomy
License No.
()
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
Provider's Taxonomy Details 6
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adolescent and Children Mental Health
Taxonomy
License No.
()
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
Provider's Taxonomy Details 7
Type
Transportation Services
Classification
Non-emergency Medical Transport (VAN)
Speciality
-
Taxonomy
License No.
084-16-001 (Virginia)
Definition
A land vehicle with a capacity to meet special height, clearance, access, and seating, for the conveyance of persons in non-emergency situations. The vehicle may or may not be required to meet local county or state regulations.
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