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Organization

LOVING GRACE HOUSE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DORIAN LEE FLOOD (OWNER)
(757) 235-9390
Entity
Organization

Contact information

Practice address
3642 RIVERSIDE DR, NORFOLK, VA 23502-4356
(757) 822-6989
Mailing address
3642 RIVERSIDE DR, NORFOLK, VA 23502-4356
(757) 822-6989

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
2310
VA

Other

Enumeration date
04/29/2015
Last updated
04/29/2015
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