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TIDERWATER YOUTH SERVICE COMMISSION
NPI 1215165451
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Portsmouth, VA

Active since June 25, 2009
2404 AIRLINE BLVD, PORTSMOUTH, VA 23701(757) 488-9382 Get Directions Write a Review

NPPES record last updated: June 25, 2009. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Tiderwater Youth Service Commission NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TIDERWATER YOUTH SERVICE COMMISSION (NPI 1215165451) is a healthcare organization registered as a community based residential treatment facility, intellectual and/or developmental disabilities in Portsmouth, Virginia and active in the NPI registry since June 2009. The organization lists Karis Holder, Counselor Coordinator, as its authorized official.

NPPES Registry Identity

NPI1215165451
Entity TypeOrganization
Primary Taxonomy320900000X
Legal Business NameTIDERWATER YOUTH SERVICE COMMISSION
Location Address2404 AIRLINE BLVDPortsmouth, VA 23701-2912
Mailing Address2404 Airline BlvdPortsmouth, VA 23701-2912 · (757) 488-9382
Phone(757) 488-9382
Organization SubpartNo
Authorized OfficialKaris HolderCounselor Coordinator · (757) 488-9382
Enumeration DateJune 25, 2009
✔ NPI 1215165451 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities
Taxonomy Code320900000X
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.
2404 AIRLINE BLVD, Portsmouth, VA 23701
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Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. TRACEY L. WILLIAMS M.S., CSAC
Counselor (Addiction (Substance Use Disorder))
2404 AIRLINE BLVD
PORTSMOUTH, VA 23701
Portsmouth City (757) 488-9382
MR. KELVIN DEWAYNE HUNTER B.A
Counselor
2404 AIRLINE BLVD
PORTSMOUTH, VA 23701
Portsmouth City (757) 488-9161
MS. JENNIFER L GUNDRUM B.S.
Counselor
2404 AIRLINE BLVD
PORTSMOUTH, VA 23701
Portsmouth City (757) 488-9382
HOPE RASHIEDA SINCLAIR
Counselor
2404 AIRLINE BLVD
PORTSMOUTH, VA 23701
Portsmouth City (757) 620-7036
MS. KASI HOWARD
Psychologist
2404 AIRLINE BLVD
PORTSMOUTH, VA 23701
Portsmouth City (757) 488-9161
SUZANNE MONIQUE LALONDE
Counselor
2404 AIRLINE BLVD
PORTSMOUTH, VA 23701
Portsmouth City (757) 488-9382
JAMES TIMOTHY HEILER
Counselor
2404 AIRLINE BLVD
PORTSMOUTH, VA 23701
Portsmouth City (757) 488-9382
MRS. SHARLA LYNNETTE SLUPSKI BA
Counselor
2404 AIRLINE BLVD
PORTSMOUTH, VA 23701
Portsmouth City (757) 615-1748

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tiderwater Youth Service Commission's NPI number?

The NPI number for Tiderwater Youth Service Commission is 1215165451. It was assigned to this organization in the NPPES registry on June 25, 2009.

Where is Tiderwater Youth Service Commission located?

Tiderwater Youth Service Commission is located at 2404 Airline Blvd, Portsmouth, VA 23701. The listed phone number is (757) 488-9382.

What is Tiderwater Youth Service Commission's specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320900000X.

When was this NPI record last updated?

The NPPES record for Tiderwater Youth Service Commission was last updated on June 25, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.