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Organization
RESIDENTIAL LIVING OPTIONS LLC
Active
Organization
RESIDENTIAL LIVING OPTIONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY LYDELL SMITH PH.D (ADMINISTRATOR)
(757) 477-1221
Entity
Organization
Contact information
Practice address
3314 LENS AVE, NORFOLK, VA 23509-2610
(757) 855-3782
Mailing address
1013 SAINT ANDREWS WAY APT C, CHESAPEAKE, VA 23320-8524
(757) 410-0229
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
725-01-001
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010109566
—
VA
Enumeration date
09/02/2006
Last updated
10/07/2008
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