Healthcare Provider Details

I. General information

NPI: 1568852747
Provider Name (Legal Business Name): WELCOME HOME COMMUNITY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2015
Last Update Date: 09/09/2022
Certification Date: 04/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4701 OWENS WAY STE 100-200
PRINCE GEORGE VA
23875-2366
US

IV. Provider business mailing address

PO BOX 247
PRINCE GEORGE VA
23875-0247
US

V. Phone/Fax

Practice location:
  • Phone: 804-458-5500
  • Fax: 804-458-5501
Mailing address:
  • Phone: 804-458-5500
  • Fax: 804-458-5501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number StateVA

VIII. Authorized Official

Name: MS. RUTHE PIERRE LAURORE
Title or Position: CHIEF EXECUTIVE DIRECTOR
Credential: LPC
Phone: 804-255-7667