Provider Demographics
NPI:1053785113
Name:PRP MANAGEMENT SERVICES, LLC
Entity type:Organization
Organization Name:PRP MANAGEMENT SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-369-4389
Mailing Address - Street 1:685 TURNBERRY BLVD
Mailing Address - Street 2:SUITE 14533
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23608-0290
Mailing Address - Country:US
Mailing Address - Phone:757-369-4389
Mailing Address - Fax:757-369-4453
Practice Address - Street 1:843 WILDERNESS WAY
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23608-1396
Practice Address - Country:US
Practice Address - Phone:757-369-4389
Practice Address - Fax:757-369-4453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-30
Last Update Date:2015-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2478-01-001320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities