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Mrs. Keysha Nicole Sparrow
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Chesapeake, Virginia
NPI 1770355489

Keysha Nicole Sparrow is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Chesapeake, VA. Keysha Nicole Sparrow practices in Chesapeake, VA. The NPI Number for Keysha Nicole Sparrow is 1770355489 and holds a License No. 8775 (Virginia).

The current practice location address for Keysha Nicole Sparrow is 2709 Blueberry Bank Ste A, Chesapeake, VA and can be reached out via phone at 757-538-7696.

Location: 2709 Blueberry Bank Ste A, Chesapeake, VA, 23325-4672
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1770355489
Provider Name
Keysha Nicole Sparrow
Credential
Provider Entity Type
Individual
Gender
Female
Address
2709 Blueberry Bank Ste A, Chesapeake, VA, 23325-4672
Phone Number
757-538-7696
Fax Number
Provider Enumeration Date
10/25/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
2709 Blueberry Bank Ste A
City
Chesapeake
State
Virginia
Zip
23325-4672
Phone Number
757-538-7696
Fax Number
person
Provider Business Mailing Address Details
Address
2709 Blueberry Bank Ste A
City
Chesapeake
State
Virginia
Zip
23325-4672
Phone Number
757-538-7696
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
8775 (Virginia)
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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