Provider Demographics
NPI:1568882470
Name:CHOSEN HANDS RESIDENTIAL HOME LLC
Entity Type:Organization
Organization Name:CHOSEN HANDS RESIDENTIAL HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:757-495-0652
Mailing Address - Street 1:1001 BANYAN DR
Mailing Address - Street 2:
Mailing Address - City:VA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-5236
Mailing Address - Country:US
Mailing Address - Phone:757-495-0652
Mailing Address - Fax:757-467-2425
Practice Address - Street 1:1001 BANYAN DR
Practice Address - Street 2:
Practice Address - City:VA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-5236
Practice Address - Country:US
Practice Address - Phone:757-495-0652
Practice Address - Fax:757-467-2425
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHOSEN HANDS RESIDENTIAL HOME LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-04-17
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities