Western Tidewater Community Services Board in Suffolk - Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities
Western Tidewater Community Services Board - NPI 1669558813
Western Tidewater Community Services Board is a Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities in Suffolk, Virginia. Western Tidewater Community Services Board practices all healthcare services and medical treatments related to Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities. The NPI Number for Western Tidewater Community Services Board is 1669558813. The last update date is 2020-08-22.
Western Tidewater Community Services Board's current location address is 5268 Godwin Blvd, Suffolk, Virginia. You can contact this provider via phone number 7572557127. The mailing address for Western Tidewater Community Services Board is 5268 Godwin Blvd, Suffolk, Virginia. To know further, please read the information below!
Provider Profile Detail
Provider Organization | Western Tidewater Community Services Board |
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Address | 5268 Godwin Blvd, Suffolk, Virginia |
Phone Number | 7572557127 |
Fax Number | |
Sole Proprietor | -- |
Credentials | -- |
Authorized Official
Title or Position | EXECUTIVE |
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Authorized Official Name | Peratsakis Demetrios |
Telephone Number | 7572557127 |
NPI Number Detail
NPI Number | 1669558813 |
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Provider Enumeration Date | 2006-10-31 |
Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
Address | 5268 Godwin Blvd |
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City | Suffolk |
State | Virginia (VA) |
Post Code | 234348135 |
Phone Number | 7572557127 |
Fax Number |
Provider's Primary Taxonomy Detail
Speciality | Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities |
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Taxonomy | 320900000X |
Definition: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities. |
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What is the unique 10-digit identification code issued to Western Tidewater Community Services Board by the Centers for Medicare & Medicaid Services?
The Western Tidewater Community Services Board has been assigned the NPI (National Provider Identifier) 1669558813 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you please provide the complete street address where Western Tidewater Community Services Board is physically located?
The Western Tidewater Community Services Board is physically situated at the following address: 5268 Godwin Blvd, Suffolk, VA, 234348135.
What is the Western Tidewater Community Services Board's specialty and taxonomy code?
The Western Tidewater Community Services Board's specialty is Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities, and the corresponding taxonomy code is 320900000X.
On what date was the 1669558813 assigned to Western Tidewater Community Services Board?
The Western Tidewater Community Services Board was issued its 1669558813 on 2006-10-31, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
When was the Western Tidewater Community Services Board's information last updated?
The Western Tidewater Community Services Board's information was last updated on 2020-08-22.