Western Tidewater Community Services Board
NPI 1275574402ActiveOrganization· Intermediate Care Facility, Intellectual Disabilities· Suffolk, VA
Intermediate Care Facility, Intellectual Disabilities in Suffolk, Virginia, registered in NPPES in June 2006. The authorized official on file is Demetrios Peratsakis, Executive Director.
Overview
| NPI | 1275574402 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 9, 2006 |
| Last updated in NPPES | Feb 28, 2023 |
| Certified by provider | Feb 28, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Intermediate Care Facility, Intellectual Disabilities Primary | 315P00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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