NPI 1033365481

Independent Living & Support Services

Organisation Case Management Agency Norfolk, VA

Practice location

Address: 1522 Florida Ave, Norfolk, VA 23502-1516
Phone: (757) 200-2094
Mailing address: 3253 Duquesne Dr, Chesapeake, VA 23321-4032

Authorised official

Name: William Anderson
Title: President/Ceo
Phone: (757) 200-2094

Registered specialties

Case Management Agency Primary

Agencies Taxonomy 251B00000X Licence SS-195-05 (VA)

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Registry record

NPI: 1033365481
Entity type: Organization
NPI issued: 15 Aug 2008
Record last updated: 15 Aug 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.