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Organization

IGNITED FAMILIES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MISS TALAYA FRALEY (CEO)
(757) 310-3063
Entity
Organization

Contact information

Practice address
308 MAPLE AVE, NEWPORT NEWS, VA 23607-4916
(757) 310-3063
Mailing address
308 MAPLE AVE, NEWPORT NEWS, VA 23607-4916
(757) 310-3063

Taxonomy

Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
NONE
VA
Enumeration date
11/07/2019
Last updated
11/07/2019
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