Provider Demographics
NPI:1376872465
Name:B&M GROUP HOMES,LLC
Entity Type:Organization
Organization Name:B&M GROUP HOMES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LEWIS
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-641-1061
Mailing Address - Street 1:4043 OLD VIRGINIA RD
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23323-1620
Mailing Address - Country:US
Mailing Address - Phone:757-641-1061
Mailing Address - Fax:866-826-6388
Practice Address - Street 1:707 NEW BERN AVE
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23669-1308
Practice Address - Country:US
Practice Address - Phone:757-637-7975
Practice Address - Fax:757-637-7975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-18
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1140320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities