Provider Demographics
NPI:1558004226
Name:BEST FRIENDS HOME LLC
Entity Type:Organization
Organization Name:BEST FRIENDS HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DON
Authorized Official - Prefix:
Authorized Official - First Name:MARIA SHIELA
Authorized Official - Middle Name:ALERA
Authorized Official - Last Name:SEVILLO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:757-752-6227
Mailing Address - Street 1:3449 POPPY CRESCENT
Mailing Address - Street 2:
Mailing Address - City:VA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23453
Mailing Address - Country:US
Mailing Address - Phone:757-752-6220
Mailing Address - Fax:757-689-0666
Practice Address - Street 1:945 EDWIN DR
Practice Address - Street 2:
Practice Address - City:VA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-3066
Practice Address - Country:US
Practice Address - Phone:757-961-4612
Practice Address - Fax:757-961-4608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-19
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services