Commonwealth Community Services LLC
Organization Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Portsmouth, VA
NPI 1003382789 · NPPES record last updated Dec 26, 2019
Key facts
- NPI
- 1003382789
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
- Legal business name
- COMMONWEALTH COMMUNITY SERVICES LLC
- Practice address
- 1512 Loren Cres
Portsmouth, VA 23701-3717 - Phone
- (757) 510-7044
- NPI assigned
- Oct 19, 2018
- Organization subpart
- No
Authorized official
- Name
- Evelyn Nowell
- Title
- Executive Director
- Phone
- (757) 510-7044
National Provider Directory
Locations
3026 Tyre Neck Rd
Portsmouth, VA 23703
Phone (757) 483-4667
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | Yes |
Addresses
Primary practice location
1512 Loren Cres
Portsmouth, VA 23701-3717
Mailing address
3026 Tyre Neck Rd
Portsmouth, VA 23703-4500
Phone (757) 510-7044
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- Commonwealth of Virginia State Board of Health
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All providers in Portsmouth, VA · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 26, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.