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Providence Community Service Llc
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Chesterfield, Virginia
NPI 1053706812

Providence Community Service Llc is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Chesterfield, VA. Providence Community Service Llc practices in Chesterfield, VA. The NPI Number for Providence Community Service Llc is 1053706812 and holds a License No. 225301001 (Virginia).

The current practice location address for Providence Community Service Llc is 7011 Egan Pl, Chesterfield, VA and can be reached out via phone at 804-674-1044 and via fax at 804-674-1110.

Location: 7011 Egan Pl, Chesterfield, VA, 23832-8310
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1053706812
Provider Name
Providence Community Service Llc
Credential
Provider Entity Type
Organization
Address
7011 Egan Pl, Chesterfield, VA, 23832-8310
Phone Number
804-674-1044
Fax Number
804-674-1110
Provider Enumeration Date
03/30/2015
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
7011 Egan Pl
City
Chesterfield
State
Virginia
Zip
23832-8310
Phone Number
804-674-1044
Fax Number
804-674-1110
person
Provider Business Mailing Address Details
Address
7011 Egan Pl
City
Chesterfield
State
Virginia
Zip
23832-8310
Phone Number
804-674-1044
Fax Number
804-674-1110
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
225301001 (Virginia)
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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