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Organization

ACACIA ADULT RESIDENTIAL SERVICES, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LORETTA PROSSER GRAHAM (PRESIDENT)
(757) 871-2477
Entity
Organization

Contact information

Practice address
50 GRANGER DR, HAMPTON, VA 23666-4633
(757) 871-2477
Mailing address
2 W GOVERNOR DR, NEWPORT NEWS, VA 23602-7431

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary

Other

Enumeration date
04/23/2017
Last updated
09/25/2018
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