Organization
EVERGLOW LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ZVISINEI MEKI DR. (CEO)
(757) 949-0950
Entity
Organization
Contact information
Practice address
4144 LAKEVIEW DR, CHESAPEAKE, VA 23323-1600
(757) 949-0950
(757) 966-2788
Mailing address
4144 LAKEVIEW DR, CHESAPEAKE, VA 23323-1600
(757) 949-0950
(757) 966-2788
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
06/15/2022
Last updated
06/15/2022
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