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General NPI Number Information
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NPI Number | 1053785113
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Entity Type | Organization
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Legal Business Name | PRP MANAGEMENT SERVICES, LLC
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Dates
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Enumeration Date | 11/30/2015
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Last Update Date | 11/30/2015
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Provider Practice Location Address
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Address Line | 843 WILDERNESS WAY
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City | NEWPORT NEWS
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State | VA
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Zip | 23608-1396
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Country | US
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Telephone | 757-369-4389
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Fax | 757-369-4453
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Provider Business Mailing Address
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Address Line | 685 TURNBERRY BLVD SUITE 14533
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City | NEWPORT NEWS
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State | VA
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Zip | 23608-0290
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Country | US
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Telephone | 757-369-4389
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Fax | 757-369-4453
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. PAMELA THOMPSON
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Credential |
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Telephone | 757-369-4389
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number | 2478-01-001
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License Number State | VA
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