Holiday House of Portsmouth, Inc.

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

Legal business name

HOLIDAY HOUSE OF PORTSMOUTH, INC.

Practice address

4211 County St
Portsmouth, VA 23707-2512

Phone

(757) 397-6352

Fax

(757) 399-2356

NPI assigned

Feb 2, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Norma Batson Megill

Title

Business Manager

Phone

(757) 397-6352

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Intermediate care facility for individuals with intellectual disabilities certification: CCN 49G013

Legal name

HOLIDAY HOUSE OF PORTSMOUTH INC

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

Oct 18, 1982

Last certification

Jan 30, 2020

Beds

28

Ownership / control type

Private (non-profit)

Facility address

4211 County Street
Portsmouth, VA 23707

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013989276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4211 COUNTY ST",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237072512",
            "telephone_number": "757-397-6352",
            "fax_number": "757-399-2356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4211 COUNTY ST",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237072512",
            "telephone_number": "757-397-6352",
            "fax_number": "757-399-2356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLIDAY HOUSE OF PORTSMOUTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MEGILL",
        "authorized_official_first_name": "NORMA",
        "authorized_official_middle_name": "BATSON",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "757-397-6352",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual Disabilities Intermediate Care Facility in Portsmouth, VA
• Providers in Portsmouth, VA by specialty
• Intellectual Disabilities Intermediate Care Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.