# AUTUMN CARE OF SUFFOLK

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366188112
- **Authorized official:** MISS LIANA GLORIA ELYSEE (SPEECH LANGUAGE PATHOLOGIST)
- **Authorized official phone:** (540) 497-3245

## Contact information

- **Practice address:** 2580 PRUDEN BLVD, SUFFOLK, VA 23434-4229
- **Practice address phone:** (757) 934-2363
- **Mailing address:** 1 SACRAMENTO DR APT 65, HAMPTON, VA 23666-1677
- **Mailing address phone:** (540) 497-3245

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 05/05/2022
- **Last updated:** 05/05/2022