Organization
WESTERN TIDEWATER COMMUNITY SERVICES BOARD
Active
Other names
Barrett House
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEMETRIOS PERATSAKIS (EXECUTIVE DIRECTOR)
(757) 255-7127
Entity
Organization
Contact information
Practice address
130 SUBURBAN DR, SUFFOLK, VA 23434-2625
(757) 255-7127
Mailing address
5268 GODWIN BLVD, SUFFOLK, VA 23434-8135
(757) 255-7127
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/31/2006
Last updated
08/22/2020
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