Healthcare Provider Details

I. General information

NPI: 1205118064
Provider Name (Legal Business Name): DEUTERONOMY EIGHT EIGHTEEN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2011
Last Update Date: 09/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6540 MONAHAN RD
RICHMOND VA
23231-6019
US

IV. Provider business mailing address

6540 MONAHAN RD
RICHMOND VA
23231-6019
US

V. Phone/Fax

Practice location:
  • Phone: 804-252-9391
  • Fax:
Mailing address:
  • Phone: 804-252-9391
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number1363
License Number StateVA

VIII. Authorized Official

Name: MRS. AMINATA WILLIAMS
Title or Position: DIRECTOR
Credential: M.S.
Phone: 804-252-9391