| Travcare Llc | |
|
1717 Holladay St Portsmouth VA 23704-2015 | |
| (757) 920-2765 | |
| Not Available |
| Full Name | Travcare Llc |
|---|---|
| Speciality | Counselor |
| Location | 1717 Holladay St, Portsmouth, Virginia |
| Authorized Official Name and Position | Latwan S Carpenter (OWNER) |
| Authorized Official Contact | 7579202765 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Travcare Llc 1717 Holladay St Portsmouth VA 23704-2015 Ph: (757) 920-2765 | Travcare Llc 1717 Holladay St Portsmouth VA 23704-2015 Ph: (757) 920-2765 |
| NPI Number | 1407539745 |
|---|---|
| Provider Enumeration Date | 08/14/2023 |
| Last Update Date | 10/19/2023 |
| Certification Date | 10/19/2023 |
| Medicare PECOS PAC ID | 0749715548 |
|---|---|
| Medicare Enrollment ID | O20241202003453 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407539745 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
| Provider Name | Latwan Carpenter |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336928787 PECOS PAC ID: 1658806450 Enrollment ID: I20241202003479 |
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