Indian River Residential Care Community
NPI #1578639654 in Chesapeake, Virginia
Provider Information
- NPI Number
- 1578639654
- Entity Type
- Organization
- Organization Name
- Indian River Residential Care Community
- Primary Specialty
- Custodial Care Facility - Adult Care Home
- Enumeration Date
- Nov 28, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 1012 JUSTIS ST
- City
- Chesapeake
- State
- Virginia
- ZIP Code
- 23325-2516
- Phone
- (757) 523-4659
Authorized Official
- Name
- GUY S PIERCE
- Title
- MANAGING MEMBER
- Phone
- (336) 595-1075
Specialties & Taxonomy Codes
| Specialty |
|---|
| Custodial Care Facility - Adult Care Home — Adult Care Home |
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