Healthcare Provider Details

I. General information

NPI: 1366716383
Provider Name (Legal Business Name): APEX DAY SUPPORT SERVICES, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2012
Last Update Date: 03/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 C GEORGE WASHINGTON HIGHWAY
CHARLOTTE COURT HOUSE VA
23923
US

IV. Provider business mailing address

PO BOX 977 6790 GEORGE WASHINGTON HIGHWAY
KEYSVILLE VA
23947-0977
US

V. Phone/Fax

Practice location:
  • Phone: 434-390-1500
  • Fax:
Mailing address:
  • Phone: 434-390-1500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number1815-02-006
License Number StateVA

VIII. Authorized Official

Name: LORENE JANE WENDELIN
Title or Position: OWNER, DIRECTOR OF ADMINISTRATION
Credential:
Phone: 434-390-1500