Provider Demographics
NPI:1992554646
Name:NIGHT & DAY KETAMINE INFUSION CENTER
Entity type:Organization
Organization Name:NIGHT & DAY KETAMINE INFUSION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CADRIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SPENCER HOPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-845-6278
Mailing Address - Street 1:3712 FESTIVAL PARK PLZ
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-4415
Mailing Address - Country:US
Mailing Address - Phone:804-454-2026
Mailing Address - Fax:
Practice Address - Street 1:3712 FESTIVAL PARK PLZ
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-4415
Practice Address - Country:US
Practice Address - Phone:804-454-2026
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty