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General NPI Number Information
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NPI Number | 1194695700
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Entity Type | Organization
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Legal Business Name | RADIANT SHORE LIVING LLC
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Dates
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Enumeration Date | 11/08/2025
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Last Update Date | 11/08/2025
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Provider Practice Location Address
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Address Line | 1859 PARKVIEW AVE
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City | NORFOLK
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State | VA
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Zip | 23503-2617
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Country | US
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Telephone | 973-619-8918
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Fax | 973-619-8918
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Provider Business Mailing Address
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Address Line | 1859 PARKVIEW AVE
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City | NORFOLK
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State | VA
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Zip | 23503-2617
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. HEMA LATCHMANSINGH
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Credential |
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Telephone | 973-619-8918
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State |
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