Organization
QUALITY LIVING OF HAMPTON ROADS,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANN MARIE BANKS (EXECUTIVE DIRECTOR)
(757) 724-2432
Entity
Organization
Contact information
Practice address
1109 FREEDOM AVE, PORTSMOUTH, VA 23701-3219
(757) 724-2432
(757) 399-8879
Mailing address
1506 PARKER AVE, PORTSMOUTH, VA 23704-4426
(757) 724-2432
(757) 399-8879
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
144401001
VA
Other
Enumeration date
01/27/2011
Last updated
01/27/2011
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