Tiderwater Youth Service Commission

NPI 1215165451 - Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities - 320900000X

NPI Details
NPI 1215165451
Enumeration Date 06/25/2009
Last Updated 06/25/2009
Entity Type Healthcare Provider
Active Over 7 years ago
Authorized Information
Name KARIS KARIS
Position COUNSELOR COORDINATOR
Phone (757) 488-9382
Fax
Practice Location
2404 AIRLINE BLVD
PORTSMOUTH VA, 23701-2912, US
Phone (757) 488-9382
Fax
Business Location
2404 AIRLINE BLVD
PORTSMOUTH VA, 23701-2912, US
Phone (757) 488-9382
Fax
Toxanomy
Taxonomy Code 320900000X
License State
License Number
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According to our database, Tiderwater Youth Service Commission NPI is 1215165451, taxonomy code is 320900000X Tiderwater Youth Service Commission physically located at 2404 Airline Blvd, Portsmouth VA, 23701-2912. NPI Number 1033115704 has the healthcare provider type.

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1215165451 NPI number is provided on an as is basis without warranty of any kind. 1215165451 is maintained by the National Plan & Provider Enumeration System. The contents of Tiderwater Youth Service Commission are for informational purposes only.