Greater Williamsburg Residential Facility, LP.

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

990 Issued in VA

Legal business name

GREATER WILLIAMSBURG RESIDENTIAL FACILITY, LP.

Doing business as

Greater Williamsburg Residential Facility

Practice address

602 Tam O Shanter Blvd
Williamsburg, VA 23185-5922

Phone

(757) 903-4236

NPI assigned

Jan 29, 2010

Last updated

Jan 29, 2010By the provider in NPPES

Organization subpart

Yes

Parent organization

DESTINYS HOUSE RESIDENTIAL SERVICES, LLC.As reported in NPPES

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

Authorized official

Name

Patrice Muhammad

Title

Executive Director

Phone

(757) 903-4236

Specialties & licenses 1

Addresses

Other names 1

• Greater Williamsburg Residential Facility Doing business as

Part of

Destiny's House Residential Services LLC

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

{
    "created_epoch": "1264723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264723200000",
    "number": "1568793669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 TAM O SHANTER BLVD",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231855922",
            "telephone_number": "757-903-4236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 TAM O SHANTER BLVD",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231855922",
            "telephone_number": "757-903-4236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER WILLIAMSBURG RESIDENTIAL FACILITY, LP.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DESTINYS HOUSE RESIDENTIAL SERVICES, LLC.",
        "enumeration_date": "2010-01-29",
        "last_updated": "2010-01-29",
        "status": "A",
        "authorized_official_last_name": "MUHAMMAD",
        "authorized_official_first_name": "PATRICE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "757-903-4236"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "VA",
            "license": "990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greater Williamsburg Residential Facility",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• John E Grasinger, MD
• Corinne Grass, SLP
• Sheila Graves, LCSW
• Jon Roger Gray, MD, MPH
• Gray's Family Services
• Green Chapter Counseling, PLLC
• Alysha M Green
• Charles William Green, NP-C
• Diane J Green, LPC
• Hannah Green

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Williamsburg, VA
• Providers in Williamsburg, VA by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2010; 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.