NPI 1285076067

Abundant Life Therapeutic Services LLC

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

Practice location

Address: 645 Church St. Suite 104c, Norfolk, VA 23510
Phone: (757) 616-0657
Fax: (757) 533-9369
Mailing address: 645 Church St Suite 104c, Norfolk, VA 23510-1712

Authorised official

Name: Melvin L Anderson
Title: Executive Director
Phone: (757) 616-0657

Registered specialties

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320600000X Licence 2154 (VA)

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

Registry record

NPI: 1285076067
Entity type: Organization
NPI issued: 22 Jul 2013
Record last updated: 5 Jun 2015

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.