CMJ Positive Change LLC

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

CMJ POSITIVE CHANGE LLC

Practice address

202 Lee St
202 Lee St
Suffolk, VA 23434-5319

Phone

(757) 923-1200

Fax

(757) 638-7662

NPI assigned

Sep 17, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Isalene D Anderson

Title

Partner

Phone

(757) 342-4183

Specialties & licenses 1

Addresses

Other names 1

• cmj positive change llc Former legal business name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1033216734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 LEE ST",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234345319",
            "telephone_number": "757-923-1200",
            "fax_number": "757-638-7662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 LEE ST",
            "address_2": "202 LEE ST",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234345319",
            "telephone_number": "757-923-1200",
            "fax_number": "757-638-7662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CMJ POSITIVE CHANGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "ISALENE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "757-342-4183",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "cmj positive change llc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Suffolk, VA
• Providers in Suffolk, VA by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.