Provider Demographics
NPI:1770330797
Name:DAY SUPPORT SERVICES OF VIRGINIA
Entity type:Organization
Organization Name:DAY SUPPORT SERVICES OF VIRGINIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DEANGELO
Authorized Official - Middle Name:
Authorized Official - Last Name:LOFTIN
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:757-215-8255
Mailing Address - Street 1:3959 RICA DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BCH
Mailing Address - State:VA
Mailing Address - Zip Code:23453-1937
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4406 INDIAN RIVER RD
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23325-3131
Practice Address - Country:US
Practice Address - Phone:757-215-8255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services