Healthcare Provider Details

I. General information

NPI: 1528984150
Provider Name (Legal Business Name): DYNAMIC WORKS PROGRAM SUPPORT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9509 HULL STREET RD STE C
NORTH CHESTERFIELD VA
23236-1494
US

IV. Provider business mailing address

PO BOX 35309
NORTH CHESTERFIELD VA
23235-0309
US

V. Phone/Fax

Practice location:
  • Phone: 804-295-5336
  • Fax: 804-295-5337
Mailing address:
  • Phone: 804-301-9449
  • Fax: 804-295-5337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. TONDREA GILES
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 804-301-9449