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Dean Vines Enterprises

Social Worker

Behavioral Health & Social Service Providers

703 Thimble Shoals Blvd, A-3, Newport News, VA 23606-2576

PECOS Enrollment

Based on the most recent information from CMS, provider Dean Vines Enterprises does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1275502106
Provider Type
Organization
Full Name
Dean Vines Enterprises

Subpart
No
Enumeration Date
3/14/2006
Last Updated
8/22/2020

Contact Information

Practice Location

703 Thimble Shoals Blvd, A-3, Newport News, VA 23606-2576

(757) 873-2307

Unlisted Fax

Mailing Location

703 Thimble Shoals Blvd, A-3, Newport News, VA 23606-2576

(757) 873-2307

Unlisted Fax

Authorized Official

Vines, Freddie Dean (President)

(757) 873-2307

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 0904002078 Virginia

Dean Vines Enterprises

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Authorized Official

Provider Taxonomies

Code

Description

License

Code

Description

License

Williams, Sara

Kabana-Ross, Cheryl

Kelly, Bonnie Jeanne

Ellis, T. Nicole

Johnson, Tonya

Oyeneyin, Shantora

Lee, Keona

Sonnier, Milov Margaret

Evans, Katherine Marie

O'Garro, Karimah Patrice