The Peninsula Community Care Center

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

2327 Issued in VA

Legal business name

THE PENINSULA COMMUNITY CARE CENTER

Practice address

913 Charlotte Dr
Newport News, VA 23601-1070

Phone

(757) 951-7432

Fax

(757) 401-6492

NPI assigned

Oct 3, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Felicia Delphine Dyke

Title

Ceo

Phone

(757) 951-7432

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1412294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412294400000",
    "number": "1821491986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CASTLE HAVEN RD",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236666032",
            "telephone_number": "757-951-7432",
            "fax_number": "757-401-6492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "913 CHARLOTTE DR",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236011070",
            "telephone_number": "757-951-7432",
            "fax_number": "757-401-6492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PENINSULA COMMUNITY CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-03",
        "last_updated": "2014-10-03",
        "status": "A",
        "authorized_official_last_name": "DYKE",
        "authorized_official_first_name": "FELICIA",
        "authorized_official_middle_name": "DELPHINE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "757-951-7432",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "VA",
            "license": "2327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2014; 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.