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General NPI Number Information
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NPI Number | 1629515929
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Entity Type | Organization
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Legal Business Name | CARE2 RESIDENTIAL SERVICES, LLC
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Dates
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Enumeration Date | 01/24/2017
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Last Update Date | 10/22/2018
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Provider Practice Location Address
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Address Line | 732 EDEN WAY N # 266
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City | CHESAPEAKE
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State | VA
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Zip | 23320-2798
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Country | US
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Telephone | 757-739-0777
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Fax |
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Provider Business Mailing Address
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Address Line | 732 EDEN WAY N # 266
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City | CHESAPEAKE
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State | VA
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Zip | 23320-2798
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Country | US
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Telephone | 757-739-0777
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Fax |
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Authorized Official
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Title or Position | QIDP
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Name | ADRIAN BROWN
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Credential | S.W.
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Telephone | 757-739-0777
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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 | 2585
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | VA
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