Provider Demographics
NPI:1952672818
Name:QUALITY COMMUNITY SUPPORTS
Entity Type:Organization
Organization Name:QUALITY COMMUNITY SUPPORTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SEBRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:PORTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-650-8878
Mailing Address - Street 1:PO BOX 1072
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23705-1072
Mailing Address - Country:US
Mailing Address - Phone:757-295-8931
Mailing Address - Fax:757-282-2990
Practice Address - Street 1:1109 EDEN SQ OFC PARK
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-2750
Practice Address - Country:US
Practice Address - Phone:757-295-8931
Practice Address - Fax:757-282-2990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-24
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA460-03-001251C00000X, 253Z00000X
VA460-05-001251S00000X
VA460-01-001320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities