House of Refuge Restoration,LLC

Primary specialty

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

Legal business name

HOUSE OF REFUGE RESTORATION,LLC

Practice address

805 Shadowberry CRST
Chesapeake, VA 23320-3544

Phone

(757) 436-2201

Fax

(877) 468-5361

NPI assigned

Nov 5, 2008

Organization subpart

No

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

Authorized official

Name

Teisha Etheridge, BS

Title

Program Director

Phone

(757) 560-1944

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• House of Refuge Ministries, LLC Other name

Tax ID family

House of Refuge2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• House of Refuge Restoration, LLC

  • Clinical Social Worker
  • Chesapeake, VA
  • NPI 1124255260
  NPD tax ID

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

{
    "created_epoch": "1225843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244505600000",
    "number": "1972757995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 SHADOWBERRY CREST",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233203544",
            "telephone_number": "757-560-1944",
            "fax_number": "877-468-5361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 SHADOWBERRY CRST",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233203544",
            "telephone_number": "757-436-2201",
            "fax_number": "877-468-5361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOUSE OF REFUGE RESTORATION,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-05",
        "last_updated": "2009-06-09",
        "status": "A",
        "authorized_official_last_name": "ETHERIDGE",
        "authorized_official_first_name": "TEISHA",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "757-560-1944",
        "authorized_official_credential": "BS"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "VA",
            "license": null,
            "primary": true
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2055X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Mental Illness, Child",
            "state": "VA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1326230640",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117414794",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "House of Refuge Ministries, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Stanley T Hoskin, LPC
• Lindsay Piccillo Houghton, NP
• George Houle, P.T.
• Teanna Houlihan
• House of Refuge Restoration, LLC
• House of Ruth, LLC
• Amia Houston, NONE
• Charlene Houston, RT
• Heidi C Houston, MSN-FNP
• Shantanita Howard

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Chesapeake, VA
• Providers in Chesapeake, 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 Jun 9, 2009; 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.