COMMONWEALTH OF VIRGINIA DEPARTMENT OF BEHAVI NPI 1114027521

NPI Information

NPI: 1114027521
Provider Name: COMMONWEALTH OF VIRGINIA DEPARTMENT OF BEHAVI
Classification: Intermediate Care Facility, Mental Illness - 310500000X
Entity Type: Organization
Doing Business As: EASTERN STATE HOSPITAL
Address: 4601 IRONBOUND RD
WILLIAMSBURG, VA
ZIP 23188
Phone: (757) 253-5241

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NPI Details

COMMONWEALTH OF VIRGINIA DEPARTMENT OF BEHAVI is an intermediate care facility mental illness in Williamsburg, VA. The provider is a nursing facility that provides an intermediate level of nursing care to individuals whose functional abilities are significantly compromise by mental illness. COMMONWEALTH OF VIRGINIA DEPARTMENT OF BEHAVI NPI is 1114027521. The provider is registered as an organization entity type.
The provider Is Doing Business As Eastern State Hospital.

The provider's business location address is:

4601 IRONBOUND RD
WILLIAMSBURG, VA
ZIP 23188-652
Phone: (757) 253-5241
Fax: (757) 253-5065

The provider's authorized official is Jack L.. Wood .
The authorized official title is Hospital Director and has the following contact phone number (757) 253-5241.

The enumeration date for this NPI number is 9/25/2006 and was last updated on 6/6/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	310500000X	Intermediate Care Facility, Mental Illness				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	004966244	MEDICAID	VIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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