Healthcare Provider Details

I. General information

NPI: 1275483794
Provider Name (Legal Business Name): A WONDERFUL OUTLOOK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2026
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

745 WESTOVER DR STE C
DANVILLE VA
24541-4628
US

IV. Provider business mailing address

225 SEDGEFIELD LN
DANVILLE VA
24541-6105
US

V. Phone/Fax

Practice location:
  • Phone: 434-857-5856
  • Fax: 434-857-5838
Mailing address:
  • Phone: 434-857-5856
  • Fax: 434-857-5838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MELISSA WALKER-JOHNSON
Title or Position: OWNER
Credential:
Phone: 434-857-5856