Provider Demographics
NPI:1922015577
Name:VERSABILITY RESOURCES, INC.
Entity Type:Organization
Organization Name:VERSABILITY RESOURCES, INC.
Other - Org Name:THE ARC OF THE VIRGINIA PENINSULA, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:'KASIA' KATHRYN
Authorized Official - Middle Name:JEANNE
Authorized Official - Last Name:GRZELKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-896-8440
Mailing Address - Street 1:2520 58TH ST
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23661-1228
Mailing Address - Country:US
Mailing Address - Phone:757-896-6461
Mailing Address - Fax:757-896-8470
Practice Address - Street 1:2520 58TH ST
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23661-1228
Practice Address - Country:US
Practice Address - Phone:757-896-6461
Practice Address - Fax:757-896-8470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-02
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA017320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA004967089Medicaid