Organization · Type 2 NPI
Western Tidewater Community Services Board
Intellectual Disabilities Intermediate Care Facility · Zuni, VA
NPI number
1104873330
Active
Practice location
22501 Thomas Woods Trl
Zuni, VA 23898-2611
Mailing address
7025 Harbour View Blvd Ste 119
Suffolk, VA 23435-2762
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual Disabilities Intermediate Care Facility Primary | 315P00000X | None listed |
Intellectual Disabilities Intermediate Care Facility: An intermediate care facility providing services for individuals with intellectual disabilities.
About NPI 1104873330
Western Tidewater Community Services Board's National Provider Identifier is 1104873330, issued on May 31, 2006. The primary taxonomy on file is Intellectual Disabilities Intermediate Care Facility (315P00000X), and the practice location is in Zuni, VA. The record was last updated on Feb 28, 2023.