Healthcare Provider Details

I. General information

NPI: 1548006588
Provider Name (Legal Business Name): PENINSULA COMMUNITY SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2024
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 DILIGENCE DR STE 227
NEWPORT NEWS VA
23606-4272
US

IV. Provider business mailing address

825 DILIGENCE DR STE 227
NEWPORT NEWS VA
23606-4272
US

V. Phone/Fax

Practice location:
  • Phone: 757-933-5386
  • Fax:
Mailing address:
  • Phone: 757-933-5386
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: CHIQUITA COLLINS
Title or Position: PROVIDER
Credential:
Phone: 757-933-5386