Organization
CHILD OF GOD GROUP HOMESLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENDRIC MCKNIGHT (ADMINISTRATOR)
(757) 810-4711
Entity
Organization
Contact information
Practice address
633 RIDGEWAY AVE, HAMPTON, VA 23661-1413
(757) 727-7807
(757) 727-9690
Mailing address
633 RIDGEWAY AVE, HAMPTON, VA 23661-1413
(757) 727-7807
(757) 727-9690
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
VA
Other
Enumeration date
10/04/2006
Last updated
08/22/2020
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