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WESTERN TIDEWATER COMMUNITY SERVICES BOARD
NPI 1386687549
Intermediate Care Facility, Intellectual Disabilities in Suffolk, VA

Active since June 14, 2006
404 FINNEY AVE, SUFFOLK, VA 23434(757) 255-7127 Get Directions Write a Review

NPPES record last updated: February 28, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 28, 2023, Aug 22, 2020 (2 updates tracked since 2020).

About Western Tidewater Community Services Board NPPES

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

WESTERN TIDEWATER COMMUNITY SERVICES BOARD (NPI 1386687549) is a healthcare organization registered as an intermediate care facility, intellectual disabilities in Suffolk, Virginia and active in the NPI registry since June 2006. The organization lists Demetrios Peratsakis, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1386687549
Entity TypeOrganization
Primary Taxonomy315P00000X
Legal Business NameWESTERN TIDEWATER COMMUNITY SERVICES BOARD
Location Address404 FINNEY AVESuffolk, VA 23434-3852
Mailing Address7025 Harbour View Blvd Ste 119Suffolk, VA 23435-2762 · (757) 966-2805 · Fax (757) 673-2586
Phone(757) 255-7127
Organization SubpartNo
Authorized OfficialDemetrios PeratsakisExecutive Director · (757) 966-2805
Enumeration DateJune 14, 2006
Last NPPES UpdateFebruary 28, 20232 updates tracked since enumeration
NPPES CertifiedFebruary 28, 2023
✔ NPI 1386687549 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyIntermediate Care Facility, Intellectual DisabilitiesNursing & Custodial Care Facilities
Taxonomy Code315P00000X
Definition
An intermediate care facility providing services for individuals with intellectual disabilities.
404 FINNEY AVE, Suffolk, VA 23434
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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 Western Tidewater Community Services Board's NPI number?

The NPI number for Western Tidewater Community Services Board is 1386687549. It was assigned to this organization in the NPPES registry on June 14, 2006.

Where is Western Tidewater Community Services Board located?

Western Tidewater Community Services Board is located at 404 Finney Ave, Suffolk, VA 23434. The listed phone number is (757) 255-7127.

What is Western Tidewater Community Services Board's specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

When was this NPI record last updated?

The NPPES record for Western Tidewater Community Services Board was last updated on February 28, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.