Loving Grace House LLC

NPI #1013394089 in Norfolk, Virginia

Provider Information

NPI Number: 1013394089
Entity Type: Organization
Organization Name: Loving Grace House LLC
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Apr 29, 2015
Last Updated: Apr 29, 2015

Practice Location

Address: 3642 RIVERSIDE DR
City: Norfolk
State: Virginia
ZIP Code: 23502-4356
Phone: (757) 822-6989

Authorized Official

Name: DORIAN LEE FLOOD
Title: OWNER
Phone: (757) 235-9390

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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