Peterson Family Care Center

Primary specialty

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

Legal business name

PETERSON FAMILY CARE CENTER

Practice address

1632 Elm Ave
Portsmouth, VA 23704-4508

Phone

(757) 399-1924

NPI assigned

Dec 22, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. James Peterson

Title

President

Phone

(757) 399-1924

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1912062860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1632 ELM AVE",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237044508",
            "telephone_number": "757-399-1924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1632 ELM AVE",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237044508",
            "telephone_number": "757-399-1924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERSON FAMILY CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "757-399-1924",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashten Person, RD
• Cord Jefferson Peters, MD
• Jacob Matthew Peters, DO
• Patricia Anne Peters, LCSW
• Christian Tyler Petersen, M.D.
• Tieasher Peterson, PHARMD
• Adrienne Dawn Pettebone, D.O.
• Darlene Petway
• Phaith Home Healthcare
• Tonga Lynn Pham

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Portsmouth, VA
• Providers in Portsmouth, 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 Aug 22, 2020; 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.