Healthcare Provider Details

I. General information

NPI: 1720685191
Provider Name (Legal Business Name): ISAIAH PEACE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2020
Last Update Date: 07/21/2025
Certification Date: 07/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 ADMIRAL GRAVELY BLVD
RICHMOND VA
23231-1201
US

IV. Provider business mailing address

805 ADMIRAL GRAVELY BLVD
RICHMOND VA
23231-1201
US

V. Phone/Fax

Practice location:
  • Phone: 804-460-9347
  • Fax: 804-918-6044
Mailing address:
  • Phone: 804-460-9347
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. LATOYA STEWARD
Title or Position: OWNER
Credential:
Phone: 804-460-9347