HOUSE OF REFUGE RESTORATIONLLC NPI 1972757995

NPI Information

NPI: 1972757995
Provider Name: HOUSE OF REFUGE RESTORATION,LLC

Other Name: HOUSE OF REFUGE MINISTRIES, LLC

Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
Entity Type: Organization
Address:
805 SHADOWBERRY CRST
CHESAPEAKE, VA
ZIP 23320
Phone: (757) 436-2201
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HOUSE OF REFUGE RESTORATION,LLC is a community based residential treatment facility, intellectual and/or developmental disabilities in Chesapeake, 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. HOUSE OF REFUGE RESTORATION,LLC NPI is 1972757995. The provider is registered as an organization entity type.
The provider Other Name Is House Of Refuge Ministries, Llc.

The provider's business location address is:

805 SHADOWBERRY CRST
CHESAPEAKE, VA
ZIP 23320-544
Phone: (757) 436-2201
Fax: (877) 468-5361

The provider's authorized official is Teisha Etheridge .
The authorized official title is Program Director and has the following contact phone number (757) 560-1944.

The enumeration date for this NPI number is 11/5/2008 and was last updated on 6/9/2009.

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 State	Primary
1	320800000X	Community Based Residential Treatment Facility, Mental Illness		VIRGINIA	No
2	322D00000X	Residential Treatment Facility, Emotionally Disturbed Children		VIRGINIA	No
3	385HR2055X	Respite Care	Respite Care, Mental Illness, Child	VIRGINIA	No
4	320900000X	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities		VIRGINIA	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	1326230640	MEDICAID	VIRGINIA
2	117414794	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: 4/28/2024

NPI Synchronization or Removal

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