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INDIAN RIVER RESIDENTIAL CARE COMMUNITY

Adult Care Home

Chesapeake, Virginia

Provider NPI: 1578639654

Organization Information:
Organization Name:  INDIAN RIVER RESIDENTIAL CARE COMMUNITY


Practice Location:
1012 JUSTIS ST  CHESAPEAKE, VA 23325 US
Tel: 757-523-4659  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y311ZA0620XNursing & Custodial Care Facilities
Custodial Care Facility
Adult Care Home
VA

Other Provider Identifiers:

IssuerNumberStateType
5002281VA05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




ADULT CARE JOBS VA - Page 1