Provider Demographics
NPI:1316715691
Name:SCL COMMUNITY CARE PARTNER
Entity type:Organization
Organization Name:SCL COMMUNITY CARE PARTNER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SERVICE FACILITATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:COOPER-LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-239-1100
Mailing Address - Street 1:2658 WINGFIELD RD
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23518-4655
Mailing Address - Country:US
Mailing Address - Phone:757-239-1100
Mailing Address - Fax:
Practice Address - Street 1:2658 WINGFIELD RD
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23518-4655
Practice Address - Country:US
Practice Address - Phone:757-239-1100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-15
Last Update Date:2024-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty