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SOUTHEASTERN VIRGINIA HEALTH SYSTEM AT WESTERN TIDEWATER COMMUNITY SER
NPI 1720462294
Clinic/Center - Federally Qualified Health Center (FQHC) in Suffolk, VA

Active since July 15, 2015
5268 GODWIN BLVD, SUFFOLK, VA 23434(757) 255-7133(757) 255-7142 Get Directions Write a Review

NPPES record last updated: July 20, 2015. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Southeastern Virginia Health System At Western Tidewater Community Ser NPPES

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

SOUTHEASTERN VIRGINIA HEALTH SYSTEM AT WESTERN TIDEWATER COMMUNITY SER (NPI 1720462294) is a healthcare organization registered as a federally qualified health center (fqhc) in Suffolk, Virginia and active in the NPI registry since July 2015. The organization lists Angela Futrell, Ceo, as its authorized official.

NPPES Registry Identity

NPI1720462294
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NamePENINSULA INSTITUTE FOR COMMUNITY HEALTH INC
Location Address5268 GODWIN BLVDSuffolk, VA 23434-8114
Mailing Address1033 28th StNewport News, VA 23607-4233 · (757) 591-0643 · Fax (757) 228-1045
Phone(757) 255-7133
Fax(757) 255-7142
Organization SubpartNo
Authorized OfficialAngela FutrellCeo · (757) 591-0643
Enumeration DateJuly 15, 2015
Last NPPES UpdateJuly 20, 2015
✔ NPI 1720462294 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
5268 GODWIN BLVD, Suffolk, VA 23434
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Other Names 1

Doing Business AsSoutheastern Virginia Health System At Western Tidewater Community Ser

Other Providers at the Same Location NPPES 14

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

LUCIANNE W WARREN LCSW
Counselor (Mental Health)
5268 GODWIN BLVD
SUFFOLK, VA 23434
Suffolk City (757) 255-7117
DR. SHERONDA FARROW PH.D.
Psychologist (Clinical)
5268 GODWIN BLVD
SUFFOLK, VA 23434
Suffolk City (757) 255-7113
MISS SHACONDA LARECE HOLLOWAY L.C.S.W.
Social Worker (Clinical)
5268 GODWIN BLVD, WESTERN TIDEWATER MENTAL HEALTH
SUFFOLK, VA 23434
Suffolk City (757) 255-7117
WESTERN TIDEWATER COMMUNITY SERVICES BOARD
Clinic/Center (Adolescent and Children Mental Health)
5268 GODWIN BLVD
SUFFOLK, VA 23434
Suffolk City (757) 255-7100
WESTERN TIDEWATER COMMUNITY MENTAL
Non-emergency Medical Transport (VAN)
5268 GODWIN BLVD
SUFFOLK, VA 23434
Suffolk City (757) 255-7117
MR. DEMETRIOS N PERATSAKIS PD, MS, LPC
Counselor (Professional)
5268 GODWIN BLVD
SUFFOLK, VA 23434
Suffolk City (757) 255-7126
TIFFANY FOX, FOX
Social Worker (Clinical)
5268 GODWIN BLVD
SUFFOLK, VA 23434
Suffolk City (757) 255-7133
BERNADETTE DENISE WARD LPC
Counselor (Professional)
5268 GODWIN BLVD
SUFFOLK, VA 23434
Suffolk City (757) 255-7107

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 Peninsula Institute For Community Health Inc's NPI number?

The NPI number for Peninsula Institute For Community Health Inc is 1720462294. It was assigned to this organization in the NPPES registry on July 15, 2015. The provider is doing business as Southeastern Virginia Health System At Western Tidewater Community Ser.

Where is Peninsula Institute For Community Health Inc located?

Peninsula Institute For Community Health Inc is located at 5268 Godwin Blvd, Suffolk, VA 23434. The listed phone number is (757) 255-7133.

What is Peninsula Institute For Community Health Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

When was this NPI record last updated?

The NPPES record for Peninsula Institute For Community Health Inc was last updated on July 20, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.