person
Kenneth Moody SR.
Intellectual and/or Developmental Disabilities Residential Treatment Facility in Hampton, Virginia
NPI 1639572068

Kenneth Moody SR. is a Intellectual and/or Developmental Disabilities Residential Treatment Facility based in Hampton, VA. Kenneth Moody SR. practices in Hampton, VA. The NPI Number for Kenneth Moody SR. is 1639572068 and holds a License No. 2599 (Virginia).

The current practice location address for Kenneth Moody SR. is 1043 Aberdeen Rd, Hampton, VA and can be reached out via phone at 757-597-1453 and via fax at 757-838-7663. You can also correspond with Kenneth Moody SR. through the mailing address at 1043 ABERDEEN RD, HAMPTON, VA - 23666-4803 (mailing address contact number: 757-597-1453).

Location: 1043 Aberdeen Rd, Hampton, VA, 23666-4803
person
Provider Profile Details
NPI Number
1639572068
Provider Name
Kenneth Moody SR.
Credential
Provider Entity Type
Individual
Gender
Male
Address
1043 Aberdeen Rd, Hampton, VA, 23666-4803
Phone Number
757-597-1453
Fax Number
757-838-7663
Provider Enumeration Date
09/30/2014
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1043 Aberdeen Rd
City
State
Zip
23666-4803
Phone Number
757-597-1453
Fax Number
757-838-7663
person
Provider Business Mailing Address Details
Address
1043 Aberdeen Rd
City
State
Zip
23666-4803
Phone Number
757-597-1453
Fax Number
757-838-7663
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
License No.
2599 (Virginia)
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
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