Western Tidewater Community Services Board
Organization Active NPI Intellectual Disabilities Intermediate Care Facility · Zuni, VA
NPI 1104873330 · NPPES record last updated Feb 28, 2023
Key facts
- NPI
- 1104873330
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Intellectual Disabilities Intermediate Care Facility 315P00000X
- Legal business name
- WESTERN TIDEWATER COMMUNITY SERVICES BOARD
- Practice address
- 22501 Thomas Woods TRL
Zuni, VA 23898-2611 - Phone
- (757) 242-4506
- NPI assigned
- May 31, 2006
- Organization subpart
- No
Authorized official
- Name
- Marion Young
- Title
- Finance Supervisor
- Phone
- (757) 687-9087
Corporate family (same tax ID) 7
National Provider Directory
- Tax ID family
- Western Tidewater Community Services Board
Locations
5268 Godwin Blvd
Suffolk, VA 23434
Phone (757) 255-7117
22501 Thomas Woods Trl
Zuni, VA 23898
Phone (757) 242-4506
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual Disabilities Intermediate Care Facility | 315P00000X | Yes |
Addresses
Primary practice location
22501 Thomas Woods TRL
Zuni, VA 23898-2611
Mailing address
7025 Harbour View Blvd Ste 119
Suffolk, VA 23435-2762
Phone (757) 687-9087
Other names
- The Neighbour's Place ICF/IID
Other providers in Zuni, VA
- Deborrah Caroline Cisneros
- Destin Pathways, LLC
- Barbara Eley
- Evangeline Eley
- Shonda Latrese Townsend
All providers in Zuni, VA · Intellectual Disabilities Intermediate Care 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 Feb 28, 2023. 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.