Organization · Type 2 NPI

Providence Community Service LLC

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Chesterfield, VA

NPI number 1053706812 Active

Practice location

7011 Egan Pl
Chesterfield, VA 23832-8310

Call (804) 674-1044 Map

Fax (804) 674-1110

Specialties and licenses

TaxonomyCodeLicense
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary 320900000X225301001 (VA)

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

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About NPI 1053706812

Providence Community Service LLC's National Provider Identifier is 1053706812, issued on Mar 30, 2015. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Chesterfield, VA. The record was last updated on Mar 30, 2015.