Organization
SKYLINE 21 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHRISTIAN NICOLE LEON (OWNER)
(757) 690-0790
Entity
Organization
Contact information
Practice address
1490 OTTERBOURNE CIR, CHESAPEAKE, VA 23320-2947
(757) 348-5510
Mailing address
1490 OTTERBOURNE CIR, CHESAPEAKE, VA 23320-2947
(757) 348-5510
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
—
—
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
VA
Other
Enumeration date
03/11/2018
Last updated
05/10/2022
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