Organization
LAV'M ADULT RESIDENCE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VICTORIA REYES MAMARIL (PRESIDENT/ADMINISTRATOR)
(757) 546-2810
Entity
Organization
Contact information
Practice address
912 SO. BATTLEFIELD BLVD., CHESAPEAKE, VA 23322-4213
(757) 546-2810
(757) 546-2921
Mailing address
912 SO. BATTLEFIELD BLVD., CHESAPEAKE, VA 23322-4213
(757) 546-2810
(757) 546-2921
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
ER02008-096
VA
Other
Enumeration date
11/10/2008
Last updated
02/23/2009
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