MEDICARE: FOUR SEASONS SUPPORTIVE LIVING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251S00000X	Community/Behavioral Health Agency
2	251B00000X	Case Management Agency
3	3104A0630X	Assisted Living Facility (Behavioral Disturbances)
4	3245S0500X	Children's Substance Abuse Rehabilitation Facility
5	253J00000X	Foster Care Agency
6	320700000X	Physical Disabilities Residential Treatment Facility
7	322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility
8	372600000X	Adult Companion
9	3104A0625X	Assisted Living Facility (Mental Illness)
10	376G00000X	Nursing Home Administrator

General Provider Information

NPI Number	:	1750237418
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOUR SEASONS SUPPORTIVE LIVING

Provider Business Mailing Address
First Line	:	119 MISTY RIDGE LN
Second Line	:
City	:	SUFFOLK
State	:	VA
Zip	:	23434-1527
Country	:	US
Telephone Number	:	757-389-3999
Fax Number	:

Provider Business Practice Location Address
First Line	:	119 MISTY RIDGE LN
Second Line	:
City	:	SUFFOLK
State	:	VA
Zip	:	23434-1527
Country	:	US
Telephone Number	:	757-389-3999
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RAMONA RODGERS
Credential	:
Telephone Number	:	757-389-3999

Provider Enumeration Date	:	03/05/2026
Last Update Date	:	03/18/2026

Similar Medicare Providers

1053059642 — WILLIAM A SULLIVAN DPT
Practice Location Address:

150 BURNETTS WAY STE 230
SUFFOLK, VA
23434-8168

Practice Phone: 757-942-2022
Practice Fax: 757-512-8997

1952259442 — QUANEISHA BARNES
Practice Location Address:

6003 RAM CT
SUFFOLK, VA
23434-7190

Practice Phone: 757-977-5762
Practice Fax:

1144178682 — SAIGE GROUP LLC
Practice Location Address:

6003 RAM CT
SUFFOLK, VA
23434-7190

Practice Phone: 757-977-5762
Practice Fax: 757-977-5762

1891642849 — VINESSA TRAMAINE OWEN MSW,SUPERVISEE IN SW
Practice Location Address:

111 MUSKET CIR
SUFFOLK, VA
23434-4088

Practice Phone: 757-698-0981
Practice Fax:

1528722329 — STACY WILLIAMS JR. PA-C
Practice Location Address:

1001 CENTERBROOKE LN
SUFFOLK, VA
23434-8663

Practice Phone: 757-702-8105
Practice Fax: 757-702-2186

1033065180 — TRAVIS FLOOD
Practice Location Address:

1849 NANSEMOND PKWY
SUFFOLK, VA
23434-2115

Practice Phone: 770-940-9186
Practice Fax:

Directions to “FOUR SEASONS SUPPORTIVE LIVING ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.