NPI 1043992241

Ebenezer Place, LLC

Organisation Intellectual and/or Developmental Disabilities Residential Treatment Facility Virginia Beach, VA

Practice location

Address: 305 Dauphin Ln, Virginia Beach, VA 23452-5407
Phone: (757) 776-7472

Authorised official

Name: Olusola Olasimbo Talabi
Title: Director
Phone: (757) 776-7472

Registered specialties

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320600000X

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Registry record

NPI: 1043992241
Entity type: Organization
NPI issued: 7 Aug 2023
Record last updated: 7 Aug 2023

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.