Individual
MRS. NIKITA S BANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CEO
Contact information
Practice address
4665 HAYGOOD RD STE 405B, VIRGINIA BEACH, VA 23455-5443
(757) 375-1483
Mailing address
4667 HAYGOOD RD STE 503E, VIRGINIA BEACH, VA 23455-5452
(757) 770-8642
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
VA
3747P1801X
Personal Care Attendant
Primary
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
852973244
—
VA
Enumeration date
09/15/2020
Last updated
05/03/2021
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