| Tidewater Regional Group Home Commission | |
|
2404 Airline Blvd Portsmouth VA 23701-2912 | |
| (757) 488-9382 | |
| (757) 488-9564 |
| Full Name | Tidewater Regional Group Home Commission |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2404 Airline Blvd, Portsmouth, Virginia |
| Authorized Official Name and Position | Linda Filippi (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7574889161 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tidewater Regional Group Home Commission 2404 Airline Blvd Portsmouth VA 23701-2912 Ph: (757) 488-9161 | Tidewater Regional Group Home Commission 2404 Airline Blvd Portsmouth VA 23701-2912 Ph: (757) 488-9382 |
| NPI Number | 1669482501 |
|---|---|
| Provider Enumeration Date | 08/09/2006 |
| Last Update Date | 11/13/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669482501 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 08305001 (Virginia) | Primary |
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