Healthcare Provider Details

I. General information

NPI: 1114644309
Provider Name (Legal Business Name): TWELVE37, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2022
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 W QUEENS WAY STE C-3
HAMPTON VA
23669-4075
US

IV. Provider business mailing address

1706 TODDS LN UNIT 306
HAMPTON VA
23666-3123
US

V. Phone/Fax

Practice location:
  • Phone: 757-769-7966
  • Fax:
Mailing address:
  • Phone: 757-769-7966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: LATHOMAS HODGE
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 757-579-0196