Healthcare Provider Details

I. General information

NPI: 1891510277
Provider Name (Legal Business Name): WELCOME HOME COMMUNITY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2024
Last Update Date: 11/20/2024
Certification Date: 11/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4701 OWENS WAY STE 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: 804-255-7667
  • Fax:
Mailing address:
  • Phone: 804-255-7667
  • 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 Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: RUTHE LAURORE
Title or Position: EXECUTIVE DIRECTOR
Credential: LPC, LMHC, BCBA, LBA
Phone: 804-458-5500