Provider Demographics
NPI:1548922461
Name:JENKINS PSYCHIATRIC SERVICES LLC
Entity type:Organization
Organization Name:JENKINS PSYCHIATRIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHEREKA
Authorized Official - Middle Name:
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:757-697-9288
Mailing Address - Street 1:742 THIMBLE SHOALS BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-3636
Mailing Address - Country:US
Mailing Address - Phone:757-697-9288
Mailing Address - Fax:757-447-2046
Practice Address - Street 1:742 THIMBLE SHOALS BLVD STE C
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-3636
Practice Address - Country:US
Practice Address - Phone:757-697-9288
Practice Address - Fax:757-447-2046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-07
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty