NPI 1700131364

Extended Love Agency Corp

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

Practice location

Address: 714 23rd St, Newport News, VA 23607-4614
Phone: (757) 380-0433

Authorised official

Name: Jacqueline Hawkins
Title: Owner
Phone: (757) 380-0433

Registered specialties

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320600000X Licence 1784 (VA)

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

Registry record

NPI: 1700131364
Entity type: Organization
NPI issued: 19 Jul 2012
Record last updated: 19 Jul 2012

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.