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General NPI Number Information
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NPI Number | 1811628357
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Entity Type | Organization
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Legal Business Name | BEST FRIENDS HOME, LLC
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Dates
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Enumeration Date | 06/23/2022
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Last Update Date | 06/24/2022
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Provider Practice Location Address
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Address Line | 3449 POPPY CRESCENT
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City | VA BEACH
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State | VA
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Zip | 23453
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Country | US
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Telephone | 757-716-3776
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Fax | 757-689-0666
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Provider Business Mailing Address
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Address Line | 3449 POPPY CRESCENT
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City | VA BEACH
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State | VA
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Zip | 23453
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Country | US
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Telephone | 757-716-3776
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Fax | 757-689-0666
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Authorized Official
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Title or Position | DON
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Name | MARIA SHIELA ALERA SEVILLO
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Credential |
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Telephone | 757-752-6227
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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