| Ida Maez Adult Living Llc | |
|
4824 George Washington Hwy Portsmouth VA 23702-2410 | |
| (757) 537-0334 | |
| Not Available |
| Full Name | Ida Maez Adult Living Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 4824 George Washington Hwy, Portsmouth, Virginia |
| Authorized Official Name and Position | Donise Anderson (CEO) |
| Authorized Official Contact | 7577719879 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ida Maez Adult Living Llc 100 7th St Ste 104 Portsmouth VA 23704-4800 Ph: (757) 771-9879 | Ida Maez Adult Living Llc 4824 George Washington Hwy Portsmouth VA 23702-2410 Ph: (757) 537-0334 |
| NPI Number | 1912688664 |
|---|---|
| Provider Enumeration Date | 07/26/2023 |
| Last Update Date | 07/26/2023 |
| Certification Date | 07/26/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912688664 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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