EPHRAIM CRUZ (NPI# 1811508252) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811508252 |
| Entity Type | Individual |
| Full Name | EPHRAIM CRUZ |
| Practice Address |
8027 Camellia Rd Norfolk VA 23518-3416 |
| Practice Telephone | 7572271105 |
| Practice Fax Number | 7572146634 |
| Mailing Telephone | 7572271105 |
| Mailing Fax Number | 7572146634 |
| Enumeration Date | 2020-08-10 |
| Last Update Date | 2020-08-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities | ||
| N | 320700000X | Residential Treatment Facility, Physical Disabilities | Residential Treatment Facilities | ||
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 29911 | VA | Residential Treatment Facilities |
| N | 343900000X | Non-emergency Medical Transport (VAN) | Transportation Services | ||
| N | 347C00000X | Private Vehicle | Transportation Services |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 81-3347603 | 05 |
| Street Address |
8027 CAMELLIA RD |
| City | NORFOLK |
| State | VA |
| Zip Code | 23518-3416 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164978656 | Camellia House LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8027 Camellia Rd, Norfolk, VA 23518-3416 | 2016-08-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538767793 | Warminster Place LLC | Public Health or Welfare | 7020 Old Mill Road, Norfolk, VA 23518 | 2020-10-11 |
| 1265907034 | Kare for All LLC | Home Health Aide | 1216 East Little Rd, Suite 200d, Norfolk, VA 23518 | 2018-10-09 |
| 1962986331 | Trinity Home Health Services, Inc | Home Health | 1301 E. Little Creek Rd #7, Norfolk, VA 23518 | 2018-09-20 |
| 1619459633 | Moataz Nasser Elmahdy | Dentist | 2338 East Little Greek Rd, Norfolk, VA 23518 | 2018-09-06 |
| 1841744752 | Syreeta Chance | Social Worker | 1500 East Little Creek Rd., Norfolk, VA 23518 | 2016-08-09 |
| 1326490004 | Elizabeth Jeanne Polinsky | Social Worker | The Relationship Center, Attn: Elizabeth Polinsky, Lcsw, 4615 Pleasant Ave., Suite B, Norfolk, VA 23518 | 2016-07-06 |
| 1255728374 | Malinda Lyon | Surgery | 8150 Shore Drive, #522, Norfolk, VA 23518 | 2015-04-16 |
| 1992054217 | Kimberly Ann Dupra | Licensed Practical Nurse | 1354 Elk Avenue, Norfolk, VA 23518 | 2012-08-31 |
| 1689963712 | Sarah Dawn Elaine Penston | Counselor | 8227 Old Ocean View Rd, Norfolk, VA 23518 | 2011-03-29 |
| 1821239690 | Elizabeth Dalton | Student in an Organized Health Care Education/Training Program | 3802 Heutte Dr., Norfolk, VA 23518 | 2009-03-09 |
| Find all providers in zip 23518 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760952592 | R&r Residential, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2714 Sewells Point Rd, Norfolk, VA 23513 | 2018-12-05 |
| 1114427218 | Patrese Onai Brown | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3571 N Ingleside Dr, Norfolk, VA 23502-4246 | 2018-02-15 |
| 1104346238 | Aza LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 944 Pollard St, Norfolk, VA 23504-1932 | 2017-06-20 |
| 1528508264 | Family Extensions, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 779 Lesner Ave, Norfolk, VA 23518-2503 | 2017-02-28 |
| 1164978656 | Camellia House LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8027 Camellia Rd, Norfolk, VA 23518-3416 | 2016-08-25 |
| 1154774008 | E D & Thomas Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2527 E Virginia Beach Blvd, Norfolk, VA 23504-3625 | 2016-07-15 |
| 1013394089 | Loving Grace House LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3642 Riverside Dr, Norfolk, VA 23502-4356 | 2015-04-29 |
| 1902203235 | Edifying Lives | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 204 W 33rd St, Norfolk, VA 23504-1408 | 2014-12-02 |
| 1063829380 | Anne's Group Home Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 722 Lexington St, Norfolk, VA 23504-2427 | 2014-07-18 |
| 1184037764 | Dailey Divine Care, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7929 Merritt St, Norfolk, VA 23518-3744 | 2014-06-11 |
| Find all providers in NORFOLK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.