Healthcare Provider Details

I. General information

NPI: 1922015577
Provider Name (Legal Business Name): VERSABILITY RESOURCES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 11/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2520 58TH ST
HAMPTON VA
23661-1228
US

IV. Provider business mailing address

2520 58TH ST
HAMPTON VA
23661-1228
US

V. Phone/Fax

Practice location:
  • Phone: 757-896-6461
  • Fax: 757-896-8470
Mailing address:
  • Phone: 757-896-6461
  • Fax: 757-896-8470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number017
License Number StateVA

VIII. Authorized Official

Name: MS. 'KASIA' KATHRYN JEANNE GRZELKOWSKI
Title or Position: PRESIDENT/CEO
Credential:
Phone: 757-896-8440