WESTERN TIDEWATER COMMUNITY MENTAL
Ambulatory Health at Godwin Blvd, Suffolk, VA

License number
Virginia 084-16-001
Category
Agencies
Type
Case Management
License number
Virginia 084-03-002
Category
Ambulatory Health
Type
Mental Health (Including Community Mental Health Center)
License number
Virginia 084-03-002
Category
Ambulatory Health
Type
Adult Mental Health
License number
Virginia 084-02-029
Category
Ambulatory Health
Type
Adolescent and Children Mental Health
Owner
Name: MR. DEMETRIOS PERATSAKIS
Title: EXECUTIVE DIRECTOR
Phone: (757) 255-7117
Address
Address
5268 Godwin Blvd, Suffolk, VA 23434
National Provider ID: 1689615296
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

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