Provider Demographics
NPI:1386277721
Name:THE MORRIS DAVIS FOUNDATION
Entity type:Organization
Organization Name:THE MORRIS DAVIS FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:DUPREE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-790-7906
Mailing Address - Street 1:PO BOX 5032
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23324-0032
Mailing Address - Country:US
Mailing Address - Phone:757-790-7906
Mailing Address - Fax:
Practice Address - Street 1:1145 COMMERCE AVE
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23324-3305
Practice Address - Country:US
Practice Address - Phone:757-790-7906
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-13
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensicGroup - Multi-Specialty
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitationGroup - Multi-Specialty