Western Tidewater Community Services Board
NPI 1689928996ActiveOrganization· Intermediate Care Facility, Intellectual Disabilities· Suffolk, VA
Intermediate Care Facility, Intellectual Disabilities in Suffolk, Virginia, registered in NPPES in November 2012. The authorized official on file is Demetrios Peratsakis, PD, MS, LPC, Executive Director.
Overview
| NPI | 1689928996 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Nov 8, 2012 |
| Last updated in NPPES | Jan 29, 2024 |
| Certified by provider | Jan 29, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Intermediate Care Facility, Intellectual Disabilities Primary | 315P00000X | 08401005 | VA |
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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