Healthcare Provider Details

I. General information

NPI: 1790628733
Provider Name (Legal Business Name): GREATER HE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10600 HAMLIN DR
CHESTER VA
23831-1186
US

IV. Provider business mailing address

10600 HAMLIN DR
CHESTER VA
23831-1186
US

V. Phone/Fax

Practice location:
  • Phone: 804-318-1062
  • Fax:
Mailing address:
  • Phone: 804-318-1062
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: JONATHAN OVERTON
Title or Position: CO OWNER
Credential:
Phone: 757-633-2016