Organization
5 STAR RESIDENTIAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL BAPTIST (DIRECTOR)
(336) 926-0133
Entity
Organization
Contact information
Practice address
5024 KELSO ST, SUFFOLK, VA 23435-2391
(336) 926-0133
Mailing address
3116 BUNCH WALNUTS RD, CHESAPEAKE, VA 23322-2904
(757) 204-4655
(757) 282-2697
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/11/2016
Last updated
05/09/2018
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