WESTERN TIDEWATER COMMUNITY SERVICES BOARD – Intellectual Disabilities Intermediate Care Facility, NPI 1275574402

WESTERN TIDEWATER COMMUNITY SERVICES BOARD is a healthcare provider. based in Suffolk, Virginia. specializing in Intellectual Disabilities Intermediate Care Facility. The organization holds a License No. 084-01-001 (VA). The NPI Number for WESTERN TIDEWATER COMMUNITY SERVICES BOARD is 1275574402

Main info

Organization
Name
WESTERN TIDEWATER COMMUNITY SERVICES BOARD
NPI
1275574402
Phone
(757) 255-7127
Address
5268 GODWIN BLVD
Authorized Official
DEMETRIOS PERATSAKIS EXECUTIVE DIRECTOR
Enumeration Date
9 June 2006
Last Update Date
28 February 2023
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience69
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for WESTERN TIDEWATER COMMUNITY SERVICES BOARD

  • Western Tidewater Community Services Board, 5268, Godwin Boulevard, Kingsdale, Suffolk, Suffolk (city), Virginia, 23434, United States

    SUFFOLK, VA 234348135

    Phone: (757) 255-7127

    Type: Mailing

  • Gq - The Wilkins, 437, Jackson Street, Philadelphia, Suffolk, Virginia, 23434, United States

    SUFFOLK, VA 234345314

    Phone: (757) 255-7127

    Type: Location

  • 7025 HARBOUR VIEW BLVD STE 119

    SUFFOLK, VA 234352762

    Phone: (757) 966-2805

    Fax: (757) 673-2586

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

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Medicare Enrollment & Revalidation

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No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

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Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 23434)

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Reviews

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Frequently asked questions

What identifier follows WESTERN TIDEWATER COMMUNITY SERVICES BOARD across health systems?
The NPI 1275574402 uniquely identifies WESTERN TIDEWATER COMMUNITY SERVICES BOARD in U.S. healthcare data.
Does the public listing show WESTERN TIDEWATER COMMUNITY SERVICES BOARD as active?
WESTERN TIDEWATER COMMUNITY SERVICES BOARD's NPI record reflects an active status in NPPES.
What type of care does WESTERN TIDEWATER COMMUNITY SERVICES BOARD provide?
WESTERN TIDEWATER COMMUNITY SERVICES BOARD's profile centers on Intellectual Disabilities Intermediate Care Facility. Clinical services aligned with this taxonomy classification.
Which community is linked to WESTERN TIDEWATER COMMUNITY SERVICES BOARD?
WESTERN TIDEWATER COMMUNITY SERVICES BOARD shows a connection to Suffolk, Virginia in registry-derived data.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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