Organization
ST MARYS HOME FOR DISABLED CHILDREN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM C GIERMAK (CEO)
(757) 622-2208
Entity
Organization
Contact information
Practice address
6171 KEMPSVILLE CIRCLE, NORFOLK, VA 23502-3930
(757) 622-2208
(757) 640-0147
Mailing address
6171 KEMPSVILLE CIRCLE, NORFOLK, VA 23502-3930
(757) 622-2208
(757) 640-0147
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
30414001
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004966333
—
VA
Enumeration date
06/26/2006
Last updated
06/25/2008
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