Provider Demographics
NPI:1336036086
Name:MARIA-GORRETTI LLC
Entity type:Organization
Organization Name:MARIA-GORRETTI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ABUTU
Authorized Official - Last Name:OBEYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-749-7595
Mailing Address - Street 1:4852 BOXFORD RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456-5010
Mailing Address - Country:US
Mailing Address - Phone:757-749-7595
Mailing Address - Fax:
Practice Address - Street 1:4852 BOXFORD RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456-5010
Practice Address - Country:US
Practice Address - Phone:757-749-7595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No253Z00000XAgenciesIn Home Supportive Care