| Granting Serentiy Group Llc | |
|
4410 Claiborne Sq E Hampton VA 23666-2071 | |
| (804) 528-9889 | |
| Not Available |
| Full Name | Granting Serentiy Group Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4410 Claiborne Sq E, Hampton, Virginia |
| Authorized Official Name and Position | Amonn Medlock (CEO) |
| Authorized Official Contact | 8045289889 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Granting Serentiy Group Llc 4410 Claiborne Sq E Hampton VA 23666-2071 Ph: (804) 528-9889 | Granting Serentiy Group Llc 4410 Claiborne Sq E Hampton VA 23666-2071 Ph: (804) 528-9889 |
| NPI Number | 1508758368 |
|---|---|
| Provider Enumeration Date | 07/16/2025 |
| Last Update Date | 07/16/2025 |
| Certification Date | 07/16/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508758368 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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