Western Tidewater Community Services Board
NPI #1689928996 in Suffolk, Virginia
Provider Information
- NPI Number
- 1689928996
- Entity Type
- Organization
- Organization Name
- Western Tidewater Community Services Board
- Primary Specialty
- Intermediate Care Facility, Intellectual Disabilities
- Enumeration Date
- Nov 8, 2012
- Last Updated
- Jan 29, 2024
Practice Location
Authorized Official
- Name
- DEMETRIOS PERATSAKIS, PD, MS, LPC
- Title
- EXECUTIVE DIRECTOR
- Phone
- (757) 255-7133
Specialties & Taxonomy Codes
| Specialty |
|---|
| Intermediate Care Facility, Intellectual Disabilities |
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