=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457516098
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PRIMEPLUS SENIOR CENTER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/23/2008
-----------------------------------------------------
Last Update Date | 09/26/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7300 NEWPORT AVENUE SUITE 100
-----------------------------------------------------
City | NORFOLK
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23505-3356
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-625-5857
-----------------------------------------------------
Fax | 757-625-5858
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | P.O. BOX 9302
-----------------------------------------------------
City | NORFOLK
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23505-3356
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-625-5857
-----------------------------------------------------
Fax | 757-625-5858
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | MR. ROBERT C BATCHER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 757-625-5857
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QA0600X
-----------------------------------------------------
Taxonomy Name | Adult Day Care Clinic/Center
-----------------------------------------------------
License Number | ERO 2008-170
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------