Healthcare Provider Details

I. General information

NPI: 1851185136
Provider Name (Legal Business Name): HAMPTON ROADS DAY SUPPORT AND LIFE SKILLS CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2025
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

507 VESPASIAN CIR
CHESAPEAKE VA
23322-6976
US

IV. Provider business mailing address

507 VESPASIAN CIR
CHESAPEAKE VA
23322-6976
US

V. Phone/Fax

Practice location:
  • Phone: 757-402-1729
  • Fax:
Mailing address:
  • Phone: 757-402-1729
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. KYERA VANDYKE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 757-402-1729