Organization
V&V ADULT GROUP HOME, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VERNON TYRONE JOHNSON (CEO)
(757) 439-0853
Entity
Organization
Contact information
Practice address
1037 SEAN DR, CHESAPEAKE, VA 23323-2727
(757) 439-0853
(757) 673-4877
Mailing address
1037 SEAN DR, CHESAPEAKE, VA 23323-2727
(757) 439-0853
(757) 673-4877
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
142101001
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0162498072
—
VA
Enumeration date
03/13/2015
Last updated
03/13/2015
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