Western Tidewater Community Services Board
Western Tidewater Community Services Board is an Intellectual Disabilities Intermediate Care Facility in Suffolk, Virginia. Licensed in Virginia. Registered with an NPI since 2012.
- Licensed in
- VA
- In the registry since
- 2012
Practice location Address checks out
4373 Pruden BlvdSuffolk, VA 23434
Phone: (757) 255-7127
Fax: (757) 255-7139
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Intellectual Disabilities Intermediate Care Facility (primary) | Taxonomy 315P00000X · Licence 08401005 (VA) |
|---|
Record details
| NPI number | 1689928996 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Demetrios Peratsakis — Executive Director · (757) 255-7133 |
| Other names | Vince'S Place/Chase'S Way Icf/Iid |
| NPI enumerated | November 8, 2012 |
| Last updated in NPPES | January 29, 2024 |
| Certification date | January 29, 2024 |
| Mailing address | 7025 Harbour View Blvd Ste 119, Suffolk, VA 23435-2762 |
Other providers in Suffolk
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Western Tidewater Community Services Board
437 Jackson St, Suffolk, VA 23434-5314 · (757) 255-7127
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Western Tidewater Community Services Board
404 Finney Ave, Suffolk, VA 23434-3852 · (757) 255-7127
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Western Tidewater Community Services Board
1406 Blythewood Ln, Suffolk, VA 23434-2804 · (757) 255-7127