Western Tidewater Community Services Board in Suffolk - Intermediate Care Facility, Intellectual Disabilities
Western Tidewater Community Services Board - NPI 1922041177
Western Tidewater Community Services Board is a Intermediate Care Facility, Intellectual Disabilities in Suffolk, Virginia. Western Tidewater Community Services Board practices all healthcare services and medical treatments related to Intermediate Care Facility, Intellectual Disabilities. The NPI Number for Western Tidewater Community Services Board is 1922041177. The last update date is 2023-02-28.
Western Tidewater Community Services Board's current location address is 7025 Harbour View Blvd Ste 119, Suffolk, Virginia. You can contact this provider via phone number 7579662805 and fax number 7576732586. The mailing address for Western Tidewater Community Services Board is 7025 Harbour View Blvd Ste 119, Suffolk, Virginia. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Western Tidewater Community Services Board |
|---|---|
| Address | 7025 Harbour View Blvd Ste 119, Suffolk, Virginia |
| Phone Number | 7579662805 |
| Fax Number | 7576732586 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | EXECUTIVE |
|---|---|
| Authorized Official Name | Peratsakis Demetrios |
| Telephone Number | 7579662805 |
NPI Number Detail
| NPI Number | 1922041177 |
|---|---|
| Provider Enumeration Date | 2006-06-14 |
| Last Updated Date | 2023-02-28 |
Provider Mailing Address Detail
| Address | 7025 Harbour View Blvd Ste 119 |
|---|---|
| City | Suffolk |
| State | Virginia (VA) |
| Post Code | 234352762 |
| Phone Number | 7579662805 |
| Fax Number | 7576732586 |
Provider's Primary Taxonomy Detail
| Speciality | Intermediate Care Facility, Intellectual Disabilities |
|---|---|
| Taxonomy | 315P00000X |
|
Definition: An intermediate care facility providing services for individuals with intellectual disabilities. |
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What is the unique identifier code issued to Western Tidewater Community Services Board by the Centers for Medicare & Medicaid Services (CMS)?
The Western Tidewater Community Services Board has been assigned the NPI (National Provider Identifier) 1922041177. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you please share the complete physical location address where Western Tidewater Community Services Board's facilities are situated?
The facilities of Western Tidewater Community Services Board are physically located at the following address: 7025 Harbour View Blvd Ste 119, Suffolk, VA, 234352762.
What is Western Tidewater Community Services Board's specialized field of practice, and what is the corresponding taxonomy classification code?
The Western Tidewater Community Services Board's area of specialization is Intermediate Care Facility, Intellectual Disabilities, and the corresponding taxonomy code that categorizes this field of practice is 315P00000X.
On what date did Western Tidewater Community Services Board receive its 1922041177 assignment from the Centers for Medicare & Medicaid Services?
The Western Tidewater Community Services Board was assigned its 1922041177 on 2006-06-14, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date was the information regarding Western Tidewater Community Services Board, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Western Tidewater Community Services Board, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2023-02-28.
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