Organization
MADONNA HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHARLENE DAVIS (ADMINISTRATOR)
(757) 435-7809
Entity
Organization
Contact information
Practice address
814 W 37TH ST, NORFOLK, VA 23508-2610
(757) 623-6662
(757) 623-4966
Mailing address
814 W 37TH ST, NORFOLK, VA 23508-2610
(757) 623-6662
(757) 623-4966
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
—
—
Other
Enumeration date
01/11/2019
Last updated
01/11/2019
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