Organization
FOUR SEASONS SUPPORTIVE LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAMONA RODGERS (OWNER)
(757) 389-3999
Entity
Organization
Contact information
Practice address
119 MISTY RIDGE LN, SUFFOLK, VA 23434-1527
(757) 389-3999
Mailing address
119 MISTY RIDGE LN, SUFFOLK, VA 23434-1527
(757) 389-3999
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253J00000X
Foster Care Agency
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
—
—
320700000X
Physical Disabilities Residential Treatment Facility
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
372600000X
Adult Companion
—
—
376G00000X
Nursing Home Administrator
Primary
—
—
Other
Enumeration date
03/05/2026
Last updated
03/18/2026
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