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Organization

VICTORY RESIDENTIAL HOME, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. SONJA DENISE CARRAWAY (CEO)
(757) 567-3292
Entity
Organization

Contact information

Practice address
440 PLUMMER DR, CHESAPEAKE, VA 23323-3116
(757) 673-4438
(757) 673-4438
Mailing address
440 PLUMMER DR, CHESAPEAKE, VA 23323-3116
(757) 673-4438
(757) 673-4438

Taxonomy

Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
2648
VA

Other

Enumeration date
04/09/2017
Last updated
04/09/2017
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