Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KENNETH MOODY SR.
Active Sole ProprietorKENNETH MOODY SR. is a Intellectual Disabilities Residential Treatment Facility healthcare provider located in HAMPTON, Virginia. NPI 1639572068 is currently active in the NPPES registry. Verify at CMS.
Intellectual Disabilities Residential Treatment Facility · HAMPTON, VA
Registration Details
- NPI Number
- 1639572068
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 30, 2014 (11.905757057171 yrs)
- Last Updated
- Sep 30, 2014
- License
-
2599 (VA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1043 ABERDEEN RDHAMPTON, VA, 236664803Browse VA providers · Browse ZIP 23666
- Phone
- 7575971453
- Fax
- 7578387663
- Primary Specialty
-
Intellectual Disabilities Residential Treatment Facility
320600000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.