Organization · Type 2 NPI
Infinite Potential Supportive Services, LLC
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · East Stone Gap, VA
Practice location
2114 Avon Street
East Stone Gap, VA 24246
Fax (276) 523-2797
Mailing address
PO Box 390, 2114 Avon Street
East Stone Gap, VA 24246-0390
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary | 320900000X | 1213 (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.
About NPI 1497070296
Infinite Potential Supportive Services, LLC's National Provider Identifier is 1497070296, issued on Apr 5, 2010. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in East Stone Gap, VA. The record was last updated on Apr 5, 2010.