Healthcare Provider Details

I. General information

NPI: 1134049109
Provider Name (Legal Business Name): CARE MADE KIND RESIDENCES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 LASSITER DR
HAMPTON VA
23666-4407
US

IV. Provider business mailing address

119 LASSITER DR
HAMPTON VA
23666-4407
US

V. Phone/Fax

Practice location:
  • Phone: 757-940-3099
  • Fax:
Mailing address:
  • Phone:
  • 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: CHEW'ON BELL
Title or Position: OWNER
Credential: RN, MSN
Phone: 757-940-3099