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General NPI Number Information
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NPI Number | 1629406905
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Entity Type | Organization
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Legal Business Name | NEHEMIAH ASSISTED LIVING FACILITY
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Dates
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Enumeration Date | 10/23/2013
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Last Update Date | 10/23/2013
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Provider Practice Location Address
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Address Line | 105 WATKINS DR
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City | HAMPTON
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State | VA
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Zip | 23669-3654
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Country | US
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Telephone | 757-224-1928
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Fax | 757-257-6388
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Provider Business Mailing Address
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Address Line | 105 WATKINS DR
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City | HAMPTON
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State | VA
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Zip | 23669-3654
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Country | US
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Telephone | 757-224-1928
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Fax | 757-257-6388
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Authorized Official
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Title or Position | ADMINNISTRATOR
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Name | MS. ERICA ELISE BAKER
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Credential |
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Telephone | 757-224-1928
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | ALF1104365
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License Number State | VA
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