Organization
AUTUMN CARE OF SUFFOLK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS LIANA GLORIA ELYSEE (SPEECH LANGUAGE PATHOLOGIST)
(540) 497-3245
Entity
Organization
Contact information
Practice address
2580 PRUDEN BLVD, SUFFOLK, VA 23434-4229
(757) 934-2363
Mailing address
1 SACRAMENTO DR APT 65, HAMPTON, VA 23666-1677
(540) 497-3245
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
05/05/2022
Last updated
05/05/2022
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