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General NPI Number Information
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NPI Number | 1881165769
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Entity Type | Organization
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Legal Business Name | ROSARIO FOUNDATION OF LIFE
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Dates
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Enumeration Date | 12/17/2018
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Last Update Date | 12/17/2018
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Provider Practice Location Address
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Address Line | 1838 BLOOMFIELD DR
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City | VIRGINIA BEACH
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State | VA
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Zip | 23453-5524
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Country | US
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Telephone | 757-773-8211
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Fax |
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Provider Business Mailing Address
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Address Line | 206 TIGERLILLY DR
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City | PORTSMOUTH
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State | VA
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Zip | 23701-2726
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Country | US
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Telephone | 757-773-8211
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. ROBERT CLAYTON ROSARIO
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Credential |
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Telephone | 757-773-8211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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