NPIMap

Organization Active NPI

Gertrude Homes LLC

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Suffolk, VA
National Provider Identifier
1073069399
Registry record updated Aug 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
2121 Issued in VA
Legal business name
GERTRUDE HOMES LLC
Practice address
7566 Quaker Dr
Suffolk, VA 23437-8906
Phone
(757) 567-0923
NPI assigned
Aug 28, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2016

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

Authorized official

Name
Clarence Russell Jr.
Title
Owner
Phone
(757) 567-0923

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 2121 VA Primary

Addresses

Primary practice location

7566 Quaker Dr
Suffolk, VA 23437-8906

Mailing address

7566 Quaker Drive
Suffolk, VA 23437-8906
Phone (757) 567-0923

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1472342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472342400000",
    "number": "1073069399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7566 QUAKER DRIVE",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234378906",
            "telephone_number": "757-567-0923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7566 QUAKER DR",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234378906",
            "telephone_number": "757-567-0923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERTRUDE HOMES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-28",
        "last_updated": "2016-08-28",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "CLARENCE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-567-0923",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "VA",
            "license": "2121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.