ST MARYS HOME FOR DISABLED CHILDREN NPI 1740217918

NPI Information

  • NPI: 1740217918
  • Provider Name: ST MARYS HOME FOR DISABLED CHILDREN
  • Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
  • Entity Type: Organization
  • CLIA Number: 49D2063468
  • Address: 6171 KEMPSVILLE CIRCLE
    NORFOLK, VA
    ZIP 23502
  • Phone: (757) 622-2208

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NPI Details

ST MARYS HOME FOR DISABLED CHILDREN is an intermediate care facility mentally retarded in Norfolk, VA. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. ST MARYS HOME FOR DISABLED CHILDREN NPI is 1740217918. The provider is registered as an organization entity type.

The provider's business location address is:

6171 KEMPSVILLE CIRCLE
NORFOLK, VA
ZIP 23502-930
Phone: (757) 622-2208
Fax: (757) 640-0147

The provider's authorized official is William C Giermak .
The authorized official title is Ceo and has the following contact phone number (757) 622-2208.

The CLIA number assigned to this NPI record is 49D2063468 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/26/2006 and was last updated on 6/25/2008.

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
1315P00000XIntermediate Care Facility, Intellectual Disabilities30414001VIRGINIAYes

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
1004966333MEDICAIDVIRGINIA

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: 3/30/2025

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