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General NPI Number Information
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NPI Number | 1225399249
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Entity Type | Organization
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Legal Business Name | F.A.C.E.S. COMMUNITY SERVICES
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Dates
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Enumeration Date | 06/06/2012
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Last Update Date | 06/06/2012
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Provider Practice Location Address
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Address Line | 3624 MARDEAN DR
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City | CHESAPEAKE
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State | VA
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Zip | 23321-4476
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Country | US
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Telephone | 757-773-9627
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Fax | 757-257-4775
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Provider Business Mailing Address
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Address Line | PO BOX 9911
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City | CHESAPEAKE
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State | VA
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Zip | 23321-0911
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Country | US
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Telephone | 757-773-9627
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Fax | 757-257-4775
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Authorized Official
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Title or Position | CEO/OWNER
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Name | MRS. ADRIANNE YVONNE SEARS
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Credential |
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Telephone | 757-773-9627
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | 1105
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License Number State | VA
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