Healthcare Provider Details

I. General information

NPI: 1609982032
Provider Name (Legal Business Name): VIABLE ADULT DAY CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 10/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4501 WILLIAMSBURG RD SUITE P
RICHMOND VA
23231-2700
US

IV. Provider business mailing address

4501 WILLIAMSBURG RD SUITE P
RICHMOND VA
23231-2700
US

V. Phone/Fax

Practice location:
  • Phone: 804-222-3355
  • Fax: 804-222-3917
Mailing address:
  • Phone: 804-222-3355
  • Fax: 804-222-3917

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License NumberCLO-06-338
License Number StateVA

VIII. Authorized Official

Name: MRS. GLORIA N ELLIOTTE
Title or Position: EXECUTIVE DIRECTOR
Credential: RN
Phone: 804-222-3355