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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