NPI 1215165451

Tiderwater Youth Service Commission

Organisation Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Portsmouth, VA

Practice location

Address: 2404 Airline Blvd, Portsmouth, VA 23701-2912
Phone: (757) 488-9382

Authorised official

Name: Karis Holder
Title: Counselor Coordinator
Phone: (757) 488-9382

Registered specialties

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320900000X

Other Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in Virginia →

Registry record

NPI: 1215165451
Entity type: Organization
NPI issued: 25 Jun 2009
Record last updated: 25 Jun 2009

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.