MEDICARE: RESIDENTIAL LIVING OPTIONS LLC

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	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility	725-01-001	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	:	1447352042
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESIDENTIAL LIVING OPTIONS LLC

Provider Business Mailing Address
First Line	:	1013 SAINT ANDREWS WAY APT C
Second Line	:
City	:	CHESAPEAKE
State	:	VA
Zip	:	23320-8524
Country	:	US
Telephone Number	:	757-410-0229
Fax Number	:

Provider Business Practice Location Address
First Line	:	3314 LENS AVE
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23509-2610
Country	:	US
Telephone Number	:	757-855-3782
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	DR. GREGORY LYDELL SMITH
Credential	:	PH.D
Telephone Number	:	757-477-1221

Provider Enumeration Date	:	09/02/2006
Last Update Date	:	10/07/2008

Similar Medicare Providers

1053372581 — SAM BAXTER AND COMPANY INC
Practice Location Address:

1842 KINGSTON AVE
NORFOLK, VA
23503-2610

Practice Phone: 757-480-3553
Practice Fax: 757-333-6855

1700222536 — ACCESSIBILITY INCORPORATED
Practice Location Address:

1842 KINGSTON AVE
NORFOLK, VA
23503-2610

Practice Phone: 757-200-9223
Practice Fax:

1750855847 — MADONNA HOME
Practice Location Address:

814 W 37TH ST
NORFOLK, VA
23508-2610

Practice Phone: 757-623-6662
Practice Fax: 757-623-4966

1053242362 — TIMELESS HEARTS TRANSPORT & LOGISTICS LLC
Practice Location Address:

549 GARREN AVE
NORFOLK, VA
23509-1632

Practice Phone: 757-297-0000
Practice Fax:

1194656850 — NITASHA HOLMAN
Practice Location Address:

2737 CHESAPEAKE BLVD
NORFOLK, VA
23509-1737

Practice Phone: 757-560-0270
Practice Fax:

1285282863 — ELIZABETH HOUSTON
Practice Location Address:

5621 TIDEWATER DR STE B
NORFOLK, VA
23509-1497

Practice Phone: 757-351-4244
Practice Fax:

Directions to “RESIDENTIAL LIVING OPTIONS LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.