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EDIFYING LIVES NPI 1902203235


NPI Information

NPI: 1902203235
Provider Name: EDIFYING LIVES
Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
Entity Type: Organization
Address:
204 W 33RD ST
NORFOLK, VA
ZIP 23504
Phone: (757) 333-9264
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EDIFYING LIVES is a community based residential treatment facility, intellectual and/or developmental disabilities in Norfolk, VA. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. EDIFYING LIVES NPI is 1902203235. The provider is registered as an organization entity type.

The provider's business location address is:

204 W 33RD ST
NORFOLK, VA
ZIP 23504-408
Phone: (757) 333-9264

The provider's authorized official is Latonya Webb .
The authorized official title is Director and has the following contact phone number (757) 333-9264.

The enumeration date for this NPI number is 12/2/2014 and was last updated on 12/2/2014.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1320900000XCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesOHS 2089VIRGINIAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
12089MEDICAIDVIRGINIA

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: 4/28/2024

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