Organization
PROVINCE PLACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARJ PANTONE (ADMINISTRATOR)
(757) 451-2400
Entity
Organization
Contact information
Practice address
6403 GRANBY ST, NORFOLK, VA 23505-4447
(757) 451-2400
Mailing address
6403 GRANBY ST, NORFOLK, VA 23505-4447
(757) 451-2400
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
07/08/2008
Last updated
07/08/2008
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