Provider Demographics
NPI:1104305945
Name:AAMEN SERVICES LLC
Entity type:Organization
Organization Name:AAMEN SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CHARLENE
Authorized Official - Middle Name:J
Authorized Official - Last Name:WIMBISH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-343-1683
Mailing Address - Street 1:1499 TIDEWATER DR
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23504-2827
Mailing Address - Country:US
Mailing Address - Phone:757-452-4356
Mailing Address - Fax:757-512-6251
Practice Address - Street 1:1499 TIDEWATER DR # B
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23504-2827
Practice Address - Country:US
Practice Address - Phone:757-343-1683
Practice Address - Fax:757-512-6251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-13
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2908-03-001261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health