NPI 1053748954

Lottie-Estelle Group Home, INC

Organisation Intellectual Disabilities Intermediate Care Facility Chase City, VA

Practice location

Address: 4897 Hwy 47, Chase City, VA 23924-3606
Phone: (434) 372-0407
Fax: (434) 372-0394
Mailing address: 4883 Hwy 47, Chase City, VA 23924-3606

Authorised official

Name: Tiffany Tillerson Terry
Title: Qmrp
Phone: (434) 372-0407

Registered specialties

Intellectual Disabilities Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 315P00000X Licence 808 (VA)

Other Intermediate Care Facility, Intellectual Disabilities providers in Virginia →

Registry record

NPI: 1053748954
Entity type: Organization
NPI issued: 9 Oct 2013
Record last updated: 9 Oct 2013

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.