Province Place

NPI #1295998458 in Norfolk, Virginia

Provider Information

NPI Number
1295998458
Entity Type
Organization
Organization Name
Province Place
Primary Specialty
Assisted Living Facility
Enumeration Date
Jul 8, 2008
Last Updated
Jul 8, 2008

Practice Location

Address
6403 GRANBY ST
ZIP Code
23505-4447
Phone
(757) 451-2400

Authorized Official

Name
MS. MARJ PANTONE
Title
ADMINISTRATOR
Phone
(757) 451-2400

Specialties & Taxonomy Codes

Specialty
Assisted Living Facility

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