Provider Demographics
NPI:1528208105
Name:VCDS VIRGINIA CONSUMER DIRECTED SERVICES
Entity Type:Organization
Organization Name:VCDS VIRGINIA CONSUMER DIRECTED SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PAM
Authorized Official - Middle Name:
Authorized Official - Last Name:FLOYD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-855-0306
Mailing Address - Street 1:520 W 21ST ST
Mailing Address - Street 2:UNIT G-2/706
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23517-1950
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:520 W 21ST ST
Practice Address - Street 2:UNIT G-2/706
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23517-1950
Practice Address - Country:US
Practice Address - Phone:757-855-0306
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-23
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management