Provider Demographics
NPI:1699073718
Name:BRENNSYL
Entity type:Organization
Organization Name:BRENNSYL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:DELAOTCH LEONARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-869-0485
Mailing Address - Street 1:514 PARLIAMENT LN
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23608-4906
Mailing Address - Country:US
Mailing Address - Phone:757-869-0485
Mailing Address - Fax:
Practice Address - Street 1:514 PARLIAMENT LN
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23608-4906
Practice Address - Country:US
Practice Address - Phone:757-869-0485
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-14
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management