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General NPI Number Information
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NPI Number | 1760145072
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Entity Type | Organization
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Legal Business Name | COMMUNITY SERVICES OF VIRGINIA INC.
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Dates
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Enumeration Date | 10/14/2021
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Last Update Date | 10/14/2021
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Provider Practice Location Address
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Address Line | 4551 PROFESSIONAL CIR STE 102
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City | VIRGINIA BEACH
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State | VA
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Zip | 23455-6442
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Country | US
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Telephone | 757-497-1115
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Fax | 757-499-4215
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Provider Business Mailing Address
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Address Line | 4551 PROFESSIONAL CIR
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City | VIRGINIA BEACH
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State | VA
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Zip | 23455-6442
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Country | US
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Telephone | 757-497-1115
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Fax | 757-499-4215
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | LORENZO CLEMONS
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Credential |
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Telephone | 757-497-1115
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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