Organization
AMETHYST CARE GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VAN DAVID WILSON III (PRESIDENT)
(757) 754-5239
Entity
Organization
Contact information
Practice address
6253 AUBURN DR, VIRGINIA BEACH, VA 23464-3714
(757) 756-4506
(866) 248-3114
Mailing address
392 S NEWTOWN RD, VIRGINIA BEACH, VA 23462-6202
(757) 754-5239
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/10/2018
Last updated
10/10/2018
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