Organization
GARRISONS SUPPORTIVE LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY PETERKIN (EXECUTIVE DIRECTOR)
(757) 779-4493
Entity
Organization
Contact information
Practice address
1253 W 27TH ST, NORFOLK, VA 23508-2442
(757) 779-4493
Mailing address
1253 W 27TH ST, NORFOLK, VA 23508-2442
(757) 779-4493
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/30/2020
Last updated
12/30/2020
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