Provider Demographics
NPI:1033693395
Name:DANIELS RESIDENTIAL LIVING
Entity type:Organization
Organization Name:DANIELS RESIDENTIAL LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ALFREDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARRINGTON-GANDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-279-4446
Mailing Address - Street 1:315 W CONSTANCE RD # 252
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-4968
Mailing Address - Country:US
Mailing Address - Phone:757-279-4446
Mailing Address - Fax:
Practice Address - Street 1:315 W CONSTANCE RD # 252
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-4968
Practice Address - Country:US
Practice Address - Phone:757-279-4446
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-21
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home