Organization
FAMILY CHOICE LIVING LLC.
Active
Other names
Family Choice Living LLC.
Organization subpart
No
Provider details
NPI number
Authorized official
DEWAYNE O'NEAL (CEO)
(757) 837-5748
Entity
Organization
Contact information
Practice address
4071 RAVINE GAP DR, SUFFOLK, VA 23434-3051
(757) 218-5884
Mailing address
4071 RAVINE GAP DR, SUFFOLK, VA 23434-3051
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00-000-3723
DBHDS
VA
Enumeration date
09/27/2022
Last updated
09/27/2022
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