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NPI Code Detail

MEDICARE: VERSABILITY RESOURCES, INC.

MEDICARE: VERSABILITY RESOURCES, INC.
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
1315P00000XIntellectual Disabilities Intermediate Care Facility017VA

General Provider Information

NPI Number : 1649315011
Entity Type Code : Organization
Provider Name (Legal Business Name) : VERSABILITY RESOURCES, INC.
Provider Business Mailing Address
First Line : 2520 58TH STREET
Second Line :
City : HAMPTON
State : VA
Zip : 23661-1228
Country : US
Telephone Number : 757-896-6461
Fax Number : 757-896-8470
Provider Business Practice Location Address
First Line : 2520 58TH STREET
Second Line :
City : HAMPTON
State : VA
Zip : 23661-1228
Country : US
Telephone Number : 757-896-6461
Fax Number : 757-896-8470
Authorized Official
Title or Position : PRESIDENT/CEO
Name : MS. KATHRYN 'KASIA' JEANNE GRZELKOWSKI
Credential :
Telephone Number : 757-896-8440
Provider Enumeration Date : 02/21/2007
Last Update Date : 11/15/2013

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