Healthcare Provider Details

I. General information

NPI: 1104663434
Provider Name (Legal Business Name): GREATER COMMUNITY SERVICES LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2024
Last Update Date: 01/18/2025
Certification Date: 01/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 HICKS RD
NORTH CHESTERFIELD VA
23235-5422
US

IV. Provider business mailing address

2501 HICKS RD
NORTH CHESTERFIELD VA
23235-5422
US

V. Phone/Fax

Practice location:
  • Phone: 804-878-2552
  • Fax:
Mailing address:
  • Phone: 804-878-2552
  • Fax:

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

VIII. Authorized Official

Name: MRS. LAVERNE REED
Title or Position: PROGRAM DIRECTOR
Credential:
Phone: 804-878-2552