NPIMap

Organization Active NPI

Western Tidewater Community Services Board

Doing business as The Neighbour's Place ICF/IID

  • Intellectual Disabilities Intermediate Care Facility
  • Zuni, VA
National Provider Identifier
1104873330
Registry record updated Feb 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
WESTERN TIDEWATER COMMUNITY SERVICES BOARD
Doing business as
The Neighbour's Place ICF/IID
Practice address
22501 Thomas Woods TRL
Zuni, VA 23898-2611
Phone
(757) 242-4506
NPI assigned
May 31, 2006
Last updated
Feb 28, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2023

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

Authorized official

Name
Marion Young
Title
Finance Supervisor
Phone
(757) 687-9087

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X Primary

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 1

  • The Neighbour's Place ICF/IID Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1104873330. Details of each certification follow.

  • CCN 49G025 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 49G025

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
NEIGHBOURS PLACE, THE
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Feb 10, 1993
Last certification
Oct 15, 2020
Beds
12
Ownership / control type
Private (non-profit)
Facility address
22501 Thomas Woods Trail
Zuni, VA 23898

National Provider Directory

National Provider Directory
Tax ID family
Western Tidewater Community Services Board8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

22501 Thomas Woods Trl
Zuni, VA 23898
Phone (757) 242-4506

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677542400000",
    "number": "1104873330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7025 HARBOUR VIEW BLVD STE 119",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234352762",
            "telephone_number": "757-687-9087",
            "fax_number": "757-673-2586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22501 THOMAS WOODS TRL",
            "city": "ZUNI",
            "state": "VA",
            "postal_code": "238982611",
            "telephone_number": "757-242-4506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN TIDEWATER COMMUNITY SERVICES BOARD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-31",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "MARION",
        "authorized_official_title_or_position": "FINANCE SUPERVISOR",
        "authorized_official_telephone_number": "757-687-9087"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Neighbour's Place ICF/IID",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Zuni, VA

Sources for this page

Verify at the official NPI Registry.