Organization
LIONESS COMMUNITY CARE OF VIRGINIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY D COLEMAN (OWNER)
(412) 712-6525
Entity
Organization
Contact information
Practice address
4445 CORPORATION LN, VIRGINIA BEACH, VA 23462-3262
(412) 712-6525
Mailing address
900 COMMONWEALTH PL STE 212, VIRGINIA BEACH, VA 23464-4529
(757) 500-8567
(888) 483-2489
Taxonomy
Speciality
Code
Description
License number
State
310500000X
Mental Illness Intermediate Care Facility
—
—
315P00000X
Intellectual Disabilities Intermediate Care Facility
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/28/2017
Last updated
07/21/2022
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