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General NPI Number Information
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NPI Number | 1346686052
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Entity Type | Organization
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Legal Business Name | CAREGROUP COMPANY LLC
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Dates
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Enumeration Date | 05/21/2013
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Last Update Date | 05/21/2013
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Provider Practice Location Address
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Address Line | 2524 LANSING AVE
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City | PORTSMOUTH
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State | VA
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Zip | 23704-6426
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Country | US
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Telephone | 757-392-3530
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Fax |
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Provider Business Mailing Address
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Address Line | 1316 SUNNYBROOK TERRACE
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City | CHESAPEAKE
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State | VA
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Zip | 23321
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Country | US
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Telephone | 757-403-6899
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Fax | 757-488-7260
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Authorized Official
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Title or Position | CEO
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Name | MRS. ANDREA DENISE BOND
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Credential |
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Telephone | 757-403-6899
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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 | 1408
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License Number State | VA
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