MEDICARE: VIABLE ADULT DAY CARE CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA0600X	Adult Day Care Clinic/Center	CLO-06-338	VA

General Provider Information

NPI Number	:	1609982032
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIABLE ADULT DAY CARE CENTER

Provider Business Mailing Address
First Line	:	4501 WILLIAMSBURG RD
Second Line	:	SUITE P
City	:	RICHMOND
State	:	VA
Zip	:	23231-2700
Country	:	US
Telephone Number	:	804-222-3355
Fax Number	:	804-222-3917

Provider Business Practice Location Address
First Line	:	4501 WILLIAMSBURG RD
Second Line	:	SUITE P
City	:	RICHMOND
State	:	VA
Zip	:	23231-2700
Country	:	US
Telephone Number	:	804-222-3355
Fax Number	:	804-222-3917

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MRS. GLORIA N ELLIOTTE
Credential	:	RN
Telephone Number	:	804-222-3355

Provider Enumeration Date	:	08/21/2006
Last Update Date	:	10/25/2013

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Directions to “VIABLE ADULT DAY CARE CENTER ” Practice Location

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