VIDAL CARE RESIDENCY LLC NPI 1447041504

NPI Information

  • NPI: 1447041504
  • Provider Name: VIDAL CARE RESIDENCY LLC
  • Classification: Assisted Living Facility - 3104A0625X
  • Specialization: Assisted Living, Mental Illness
  • Entity Type: Organization
  • Address: 109 CROCKER ST
    SUFFOLK, VA
    ZIP 23434
  • Phone: (757) 809-0301

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NPI Details

VIDAL CARE RESIDENCY LLC is an assisted living and mental illness assisted living facility in Suffolk, VA. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. VIDAL CARE RESIDENCY LLC NPI is 1447041504. The provider is registered as an organization entity type.

The provider's business location address is:

109 CROCKER ST
SUFFOLK, VA
ZIP 23434-605
Phone: (757) 809-0301

The provider's authorized official is Leary Williams .
The authorized official title is Co-owner and has the following contact phone number (757) 609-1534.

The enumeration date for this NPI number is 5/16/2025 and was last updated on 5/16/2025.

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
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)No
2251S00000XCommunity/Behavioral HealthNo
3253Z00000XIn Home Supportive CareNo
43104A0625XAssisted Living FacilityAssisted Living, Mental IllnessYes

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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