Healthcare Provider Details

I. General information

NPI: 1689023111
Provider Name (Legal Business Name): KD SONS & SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2016
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1108 SIR GAWAINE DR
CHESAPEAKE VA
23323-2835
US

IV. Provider business mailing address

3714 BREEZE PORT ARCH
CHESAPEAKE VA
23321-3183
US

V. Phone/Fax

Practice location:
  • Phone: 757-337-0945
  • Fax:
Mailing address:
  • Phone: 757-450-4688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number StateVA

VIII. Authorized Official

Name: MRS. KIMBERLY POITTILO HUNT
Title or Position: CEO
Credential: M.ED
Phone: 757-450-4688