Provider Demographics
NPI:1295900637
Name:MOTHER SETON HOUSE
Entity type:Organization
Organization Name:MOTHER SETON HOUSE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:SALEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-963-5795
Mailing Address - Street 1:465 KINGS GRANT RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-6920
Mailing Address - Country:US
Mailing Address - Phone:757-306-1840
Mailing Address - Fax:757-306-1843
Practice Address - Street 1:465 KINGS GRANT RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-6920
Practice Address - Country:US
Practice Address - Phone:757-306-1840
Practice Address - Fax:757-306-1843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VASS-152-06322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children