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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. You can also correspond with Ephraim Cruz through the mailing address at 8027 CAMELLIA RD, NORFOLK, VA - 23518-3416 (mailing address contact number: 757-227-1105).

Location: 8027 Camellia Rd, Norfolk, VA, 23518-3416
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
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
Norfolk
State
Virginia
Zip
23518-3416
Phone Number
757-227-1105
Fax Number
757-214-6634
person
Provider Business Mailing Address Details
Address
8027 Camellia Rd
City
Norfolk
State
Virginia
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
320600000X
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.
person
Provider's Taxonomy Details 2
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Physical Disabilities
Speciality
-
Taxonomy
320700000X
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
320900000X
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
343900000X
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.
person
Provider's Taxonomy Details 5
Type
Transportation Services
Classification
Private Vehicle
Speciality
-
Taxonomy
347C00000X
License No.
()
Definition
An individual paid to provide non-emergency transportation using their privately owned/leased vehicle.
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