Individual provider · Type 1 NPI
Damon Peterson, M.ED, PBSF
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Petersburg, VA
Practice location
24812 Brickwood Meadow Ln
Petersburg, VA 23803-8869
Mailing address
PO Box 334
Petersburg, VA 23804-0334
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary | 320900000X | 148 (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.
Other intellectual and/or developmental disabilities community based residential treatment facility providers in Petersburg
About NPI 1194042515
Damon Peterson, M.ED, PBSF's National Provider Identifier is 1194042515, issued on Apr 24, 2010. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Petersburg, VA. The record was last updated on Apr 24, 2010.