Provider Demographics
NPI:1912671447
Name:ACCUCARE GROUP HOME, LLC
Entity Type:Organization
Organization Name:ACCUCARE GROUP HOME, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARLITO
Authorized Official - Middle Name:
Authorized Official - Last Name:OROBIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-773-8121
Mailing Address - Street 1:PO BOX 66003
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23466-6003
Mailing Address - Country:US
Mailing Address - Phone:757-773-8121
Mailing Address - Fax:
Practice Address - Street 1:3477 JOHNS ST
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23513-1654
Practice Address - Country:US
Practice Address - Phone:757-937-0517
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-07
Last Update Date:2021-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities