Southside Group Homes, LLC
NPI #1386208270 in Portsmouth, Virginia
Provider Information
- NPI Number
- 1386208270
- Entity Type
- Organization
- Organization Name
- Southside Group Homes, LLC
- Primary Specialty
- Community/Behavioral Health
- Enumeration Date
- Apr 25, 2019
- Last Updated
- Apr 25, 2019
Practice Location
- Address
- 3400 AIRLINE BLVD
- City
- Portsmouth
- State
- Virginia
- ZIP Code
- 23701-2623
- Phone
- (757) 673-1483
Authorized Official
- Name
- LISA ANN ILAPIT
- Title
- OWNER
- Phone
- (757) 362-1479
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community/Behavioral Health |
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