Provider Demographics
NPI:1205986676
Name:ATTACHMENT AND TRAUMA INSTITUTE, LLC
Entity type:Organization
Organization Name:ATTACHMENT AND TRAUMA INSTITUTE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:V
Authorized Official - Last Name:OWEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-289-5885
Mailing Address - Street 1:208 E PLUME ST
Mailing Address - Street 2:#228
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23510-1757
Mailing Address - Country:US
Mailing Address - Phone:757-289-5885
Mailing Address - Fax:757-622-2011
Practice Address - Street 1:4114 E PARHAM RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23228-2759
Practice Address - Country:US
Practice Address - Phone:804-901-7911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services