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General NPI Number Information
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NPI Number | 1235461070
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Entity Type | Organization
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Legal Business Name | DUBIES LOVE RESIDENTIAL SERVICES LLC
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Dates
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Enumeration Date | 02/04/2010
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Last Update Date | 10/16/2017
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Provider Practice Location Address
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Address Line | 2500 ALMEDA AVE STE 114
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City | NORFOLK
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State | VA
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Zip | 23513-2403
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Country | US
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Telephone | 757-408-0718
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Fax |
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Provider Business Mailing Address
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Address Line | 2500 ALMEDA AVE STE 114
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City | NORFOLK
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State | VA
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Zip | 23513-2403
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Country | US
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Telephone | 757-408-0718
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | RHONDA ANN TAYLOR
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Credential |
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Telephone | 757-718-7680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | 1339
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License Number State | VA
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