Healthcare Provider Details

I. General information

NPI: 1255113247
Provider Name (Legal Business Name): CHESTERFIELD ADULT DAYCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2023
Last Update Date: 10/16/2023
Certification Date: 10/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14221 ROCKYRUN RD
CHESTERFIELD VA
23838-6265
US

IV. Provider business mailing address

14221 ROCKYRUN RD
CHESTERFIELD VA
23838-6265
US

V. Phone/Fax

Practice location:
  • Phone: 804-325-9893
  • Fax:
Mailing address:
  • Phone: 804-325-9893
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KATE APPIAH
Title or Position: MEMBER
Credential:
Phone: 804-325-9893