Organization
SOUTHEASTERN VIRGINIA AREAWIDE MODEL PROGRAM
Active
Organization
SOUTHEASTERN VIRGINIA AREAWIDE MODEL PROGRAM
Active
Other names
Senior Services of Southeastern Virginia
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN N SKIRVEN (CEO)
(757) 222-4510
Entity
Organization
Contact information
Practice address
6350 CENTER DR, SUITE101, NORFOLK, VA 23502-4107
(757) 461-9481
(757) 461-1068
Mailing address
6350 CENTER DR, SUITE101, NORFOLK, VA 23502-4107
(757) 461-9481
(757) 461-1068
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
1060267354
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0160267354
—
VA
05
—
0161745051
—
VA
Enumeration date
06/10/2014
Last updated
06/10/2014
Update your record
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