Healthcare Provider Details

I. General information

NPI: 1154024800
Provider Name (Legal Business Name): CORNER OF LIFE FAMILY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2023
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 TYRE NECK RD 3300 TYRE NECK RD
PORTSMOUTH VA
23703-3319
US

IV. Provider business mailing address

3300 TYRE NECK RD 3300 TYRE NECK RD
PORTSMOUTH VA
23703-3319
US

V. Phone/Fax

Practice location:
  • Phone: 757-288-1609
  • Fax:
Mailing address:
  • Phone: 757-288-1609
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. NORINE L PATRICK
Title or Position: CEO
Credential:
Phone: 757-450-8264