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Ephraim Cruz
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Norfolk, Virginia
NPI 1811508252

Ephraim Cruz is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Norfolk, VA. Ephraim Cruz practices in Norfolk, VA. The NPI Number for Ephraim Cruz is 1811508252 and holds a License No. (Virginia).

The current practice location address for Ephraim Cruz is 8027 Camellia Rd, Norfolk, VA and can be reached out via phone at 757-227-1105 and via fax at 757-214-6634.

Location: 8027 Camellia Rd, Norfolk, VA, 23518-3416
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Provider Profile Details
NPI Number
1811508252
Provider Name
Ephraim Cruz
Credential
Provider Entity Type
Individual
Gender
Male
Address
8027 Camellia Rd, Norfolk, VA, 23518-3416
Phone Number
757-227-1105
Fax Number
757-214-6634
Provider Enumeration Date
08/10/2020
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
81-3347603 05 VA
institution
Provider Business Practice Location Address Details
Address
8027 Camellia Rd
City
State
Zip
23518-3416
Phone Number
757-227-1105
Fax Number
757-214-6634
person
Provider Business Mailing Address Details
Address
8027 Camellia Rd
City
State
Zip
23518-3416
Phone Number
757-227-1105
Fax Number
757-214-6634
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
License No.
29911 (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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Provider's Taxonomy Details 2
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Physical Disabilities
Speciality
-
Taxonomy
License No.
()
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with physical disabilities and are not able to live independently.
person
Provider's Taxonomy Details 3
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
License No.
()
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
person
Provider's Taxonomy Details 4
Type
Transportation Services
Classification
Non-emergency Medical Transport (VAN)
Speciality
-
Taxonomy
License No.
()
Definition
A land vehicle with a capacity to meet special height, clearance, access, and seating, for the conveyance of persons in non-emergency situations. The vehicle may or may not be required to meet local county or state regulations.
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Provider's Taxonomy Details 5
Type
Transportation Services
Classification
Private Vehicle
Speciality
-
Taxonomy
License No.
()
Definition
An individual paid to provide non-emergency transportation using their privately owned/leased vehicle.
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