Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Western Tidewater Community Services Board

Organization Intellectual Disabilities Intermediate Care Facility · NPI 1386687549

Western Tidewater Community Services Board is an Intellectual Disabilities Intermediate Care Facility in Suffolk, Virginia. Registered with an NPI since 2006.

In the registry since
2006

Practice location Address checks out

404 Finney Ave
Suffolk, VA 23434-3852
Phone: (757) 255-7127
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Intellectual Disabilities Intermediate Care Facility (primary) Taxonomy 315P00000X

Record details

NPI number1386687549
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Demetrios Peratsakis — Executive Director · (757) 966-2805
NPI enumeratedJune 14, 2006
Last updated in NPPESFebruary 28, 2023
Certification dateFebruary 28, 2023
Mailing address7025 Harbour View Blvd Ste 119, Suffolk, VA 23435-2762

Other providers in Suffolk