Healthcare Provider Details

I. General information

NPI: 1073209649
Provider Name (Legal Business Name): BETTER LIVING RESIDENTIAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2023
Last Update Date: 04/17/2023
Certification Date: 04/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5131 HACKNEY RD
NORTH CHESTERFIELD VA
23234-4519
US

IV. Provider business mailing address

12619 LERWICK PL
CHESTERFIELD VA
23838-5546
US

V. Phone/Fax

Practice location:
  • Phone: 804-651-8196
  • Fax: 510-323-8161
Mailing address:
  • Phone: 804-651-8196
  • Fax: 510-323-8161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code320700000X
TaxonomyPhysical Disabilities Residential Treatment Facility
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: VALERIE L THOMAS
Title or Position: VICE PRESIDENT
Credential: BSHCA, QMHP-A
Phone: 804-651-8196