Healthcare Provider Details

I. General information

NPI: 1396097341
Provider Name (Legal Business Name): EASTERN VIRGINIA ADULT CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2012
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13193 WARWICK BLVD STE 105
NEWPORT NEWS VA
23602-8320
US

IV. Provider business mailing address

13193 WARWICK BLVD STE 105
NEWPORT NEWS VA
23602-8320
US

V. Phone/Fax

Practice location:
  • Phone: 757-898-7524
  • Fax:
Mailing address:
  • Phone: 757-898-7524
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number2066
License Number StateVA

VIII. Authorized Official

Name: DIONA M SHEFFIELD
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 757-898-7524