Western Tidewater Community Services Board
NPI #1275574402 in Suffolk, Virginia
Provider Information
- NPI Number
- 1275574402
- Entity Type
- Organization
- Organization Name
- Western Tidewater Community Services Board
- Primary Specialty
- Intermediate Care Facility, Intellectual Disabilities
- Enumeration Date
- Jun 9, 2006
- Last Updated
- Feb 28, 2023
Practice Location
Authorized Official
- Name
- DEMETRIOS PERATSAKIS
- Title
- EXECUTIVE DIRECTOR
- Phone
- (757) 966-2805
Specialties & Taxonomy Codes
| Specialty |
|---|
| Intermediate Care Facility, Intellectual Disabilities |
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