Organization
PRISSY'S PLACE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRISCILLA ANTOINETTE WEST DOCTORATE ED. (DIRECTOR)
(757) 487-6441
Entity
Organization
Contact information
Practice address
505 ROOSEVELT BLVD, PORTSMOUTH, VA 23701-4118
(757) 487-6441
Mailing address
505 ROOSEVELT BLVD, PORTSMOUTH, VA 23701-4118
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/21/2014
Last updated
11/21/2014
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