Healthcare Provider Details

I. General information

NPI: 1730012477
Provider Name (Legal Business Name): TRIUMPH HOMES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 MICHAELS WOODS DR
HAMPTON VA
23666-5627
US

IV. Provider business mailing address

225 DILLON DR
VIRGINIA BEACH VA
23452-6735
US

V. Phone/Fax

Practice location:
  • Phone: 757-563-3694
  • Fax:
Mailing address:
  • Phone:
  • 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 State

VIII. Authorized Official

Name: LATARSHA DREUITT
Title or Position: OWNER
Credential:
Phone: 757-563-3694