Organization · Type 2 NPI
Western Tidewater Community Services Board
Intellectual Disabilities Intermediate Care Facility · Suffolk, VA
NPI number
1275574402
Active
Practice location
437 Jackson St
Suffolk, VA 23434-5314
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.
Other intellectual disabilities intermediate care facility providers in Suffolk
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About NPI 1275574402
Western Tidewater Community Services Board's National Provider Identifier is 1275574402, issued on Jun 9, 2006. The primary taxonomy on file is Intellectual Disabilities Intermediate Care Facility (315P00000X), and the practice location is in Suffolk, VA. The record was last updated on Feb 28, 2023.