Organization · Type 2 NPI

Tiderwater Youth Service Commission

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Portsmouth, VA

NPI number 1215165451 Active

Practice location

2404 Airline Blvd
Portsmouth, VA 23701-2912

Call (757) 488-9382 Map

Specialties and licenses

TaxonomyCodeLicense
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary 320900000XNone listed

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

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About NPI 1215165451

Tiderwater Youth Service Commission's National Provider Identifier is 1215165451, issued on Jun 25, 2009. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Portsmouth, VA. The record was last updated on Jun 25, 2009.