MEDICARE: CITY OF VIRGINIA BEACH HUMAN SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	315P00000X	Intellectual Disabilities Intermediate Care Facility	261-01-001	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407917347
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF VIRGINIA BEACH HUMAN SERVICES

Provider Business Mailing Address
First Line	:	3432 VIRGINIA BEACH BLVD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23452-4420
Country	:	US
Telephone Number	:
Fax Number	:	757-306-5801

Provider Business Practice Location Address
First Line	:	145 S KENTUCKY AVE
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23452-2382
Country	:	US
Telephone Number	:	757-437-6275
Fax Number	:

Authorized Official
Title or Position	:	REIMBURSEMENT MANAGER
Name	:	MARGARET G BAILEY
Credential	:
Telephone Number	:	757-385-0687

Provider Enumeration Date	:	12/13/2006
Last Update Date	:	04/18/2022

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