Healthcare Provider Details

I. General information

NPI: 1669854220
Provider Name (Legal Business Name): SWIFT CREEK DAY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2015
Last Update Date: 06/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2806 FOX CHASE LN
MIDLOTHIAN VA
23112-4008
US

IV. Provider business mailing address

2806 FOX CHASE LN
MIDLOTHIAN VA
23112-4008
US

V. Phone/Fax

Practice location:
  • Phone: 804-744-7653
  • Fax:
Mailing address:
  • Phone: 804-744-7653
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License NumberADC14-1103676
License Number StateVA

VIII. Authorized Official

Name: BRITTANY RAWLINSON
Title or Position: DIRECTOR
Credential:
Phone: 804-744-7412