Amazing Community Service LLC

Primary specialty

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

Legal business name

AMAZING COMMUNITY SERVICE LLC

Practice address

1412 Vance Cir
Chesapeake, VA 23320-3262

Phone

(757) 739-6359

NPI assigned

Oct 18, 2023

Last updated

Oct 18, 2023By 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

Evangelene Medley

Title

Ceo

Phone

(757) 739-6359

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1697587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697587200000",
    "number": "1780466326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 VANCE CIR",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233203262",
            "telephone_number": "757-739-6359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 VANCE CIR",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233203262",
            "telephone_number": "757-739-6359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMAZING COMMUNITY SERVICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-18",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A",
        "authorized_official_last_name": "MEDLEY",
        "authorized_official_first_name": "EVANGELENE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "757-739-6359"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; 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.