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General NPI Number Information
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NPI Number | 1306281779
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Entity Type | Organization
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Legal Business Name | WECARE COMMUNITY SERVICES, LLC
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Dates
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Enumeration Date | 04/30/2013
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Last Update Date | 04/30/2013
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Provider Practice Location Address
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Address Line | 3953 WILMINGTON RD
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City | VIRGINIA BEACH
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State | VA
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Zip | 23453-1739
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Country | US
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Telephone | 757-471-0012
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Fax | 757-471-0013
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Provider Business Mailing Address
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Address Line | 3953 WILMINGTON RD
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City | VIRGINIA BEACH
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State | VA
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Zip | 23453-1739
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Country | US
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Telephone | 757-471-0012
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Fax | 757-471-0013
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JEMMALYN ANONUEVO HEWLETT
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Credential |
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Telephone | 757-471-0012
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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 | 173701001
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License Number State | VA
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