Organization · Type 2 NPI
Western Tidewater Community Services Board
Intellectual Disabilities Intermediate Care Facility · Suffolk, VA
NPI number
1922041177
Active
Practice location
1406 Blythewood Ln
Suffolk, VA 23434-2804
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 1922041177
Western Tidewater Community Services Board's National Provider Identifier is 1922041177, issued on Jun 14, 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.