Individual
MRS. LACHUNTE' GRESHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
610 WOODFIN RD, NEWPORT NEWS, VA 23605-1138
(757) 236-0864
Mailing address
610 WOODFIN RD, NEWPORT NEWS, VA 23605-1138
(757) 236-0864
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
118497930
DUN NUMBER
VA
Enumeration date
04/27/2022
Last updated
04/27/2022
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