Provider Demographics
NPI: | 1467015834 |
---|---|
Name: | GLASCOW HEALTH SERVICES LLC |
Entity type: | Organization |
Organization Name: | GLASCOW HEALTH SERVICES LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | MANAGING PARTNER |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | TRENTON |
Authorized Official - Middle Name: | L |
Authorized Official - Last Name: | WALKER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 757-435-9251 |
Mailing Address - Street 1: | 301 GOODE WAY STE 105 |
Mailing Address - Street 2: | |
Mailing Address - City: | PORTSMOUTH |
Mailing Address - State: | VA |
Mailing Address - Zip Code: | 23704-2266 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 757-435-9251 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 301 GOODE WAY STE 105 |
Practice Address - Street 2: | |
Practice Address - City: | PORTSMOUTH |
Practice Address - State: | VA |
Practice Address - Zip Code: | 23704-2266 |
Practice Address - Country: | US |
Practice Address - Phone: | 757-435-9251 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2019-04-20 |
Last Update Date: | 2025-09-16 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 261QM0855X | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health | |
No | 2083P0500X | Allopathic & Osteopathic Physicians | Preventive Medicine | Preventive Medicine/Occupational Environmental Medicine | Group - Multi-Specialty |
No | 320800000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Mental Illness | ||
No | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) | |
No | 106H00000X | Behavioral Health & Social Service Providers | Marriage & Family Therapist | Group - Multi-Specialty | |
No | 251B00000X | Agencies | Case Management | ||
No | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Multi-Specialty |
No | 261QR0405X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder | |
No | 103TP2701X | Behavioral Health & Social Service Providers | Psychologist | Group Psychotherapy | Group - Multi-Specialty |
No | 251S00000X | Agencies | Community/Behavioral Health | ||
No | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Multi-Specialty |
No | 320900000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | ||
No | 261QM0850X | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health |