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Organization
VIDAL CARE RESIDENCY LLC
Active
Organization
VIDAL CARE RESIDENCY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEARY WILLIAMS (CO-OWNER)
(757) 609-1534
Entity
Organization
Contact information
Practice address
109 CROCKER ST, SUFFOLK, VA 23434-2605
(757) 809-0301
Mailing address
126 BOWRIDER DR, SUFFOLK, VA 23435-4117
(757) 609-1534
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
—
—
Other
Enumeration date
05/16/2025
Last updated
05/16/2025
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