Organization
THE VILLAGE OF TIDEWATER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAQUANNA TIMISHA GODWIN (ADMINISTRATOR)
(757) 937-5991
Entity
Organization
Contact information
Practice address
1001 E 26TH ST STE 1, NORFOLK, VA 23504-1801
(757) 937-5991
Mailing address
1001 E 26TH ST STE 1, NORFOLK, VA 23504-1801
(757) 937-5991
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
11/18/2025
Last updated
11/18/2025
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