Organization
COMMONWEALTH COMMUNITY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVELYN NOWELL (EXECUTIVE DIRECTOR)
(757) 510-7044
Entity
Organization
Contact information
Practice address
1512 LOREN CRES, PORTSMOUTH, VA 23701-3717
(757) 510-7044
Mailing address
3026 TYRE NECK RD, PORTSMOUTH, VA 23703-4500
(757) 510-7044
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/19/2018
Last updated
12/26/2019
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