Organization
QUALITY COMMUNITY SUPPORTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SEBRINA PORTER (PRESIDENT)
(757) 650-8878
Entity
Organization
Contact information
Practice address
1109 EDEN SQ OFC PARK, CHESAPEAKE, VA 23320-2750
(757) 295-8931
(757) 282-2990
Mailing address
PO BOX 1072, PORTSMOUTH, VA 23705-1072
(757) 295-8931
(757) 282-2990
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
460-03-001
VA
251S00000X
Community/Behavioral Health Agency
460-05-001
VA
253Z00000X
In Home Supportive Care Agency
460-03-001
VA
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
460-01-001
VA
Other
Enumeration date
01/24/2012
Last updated
01/24/2012
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