Healthcare Provider Details

I. General information

NPI: 1083620744
Provider Name (Legal Business Name): VELDOT RESIDENTIAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 LAURELWOOD RD
RICHMOND VA
23234-3220
US

IV. Provider business mailing address

4000 LAURELWOOD RD
RICHMOND VA
23234-3220
US

V. Phone/Fax

Practice location:
  • Phone: 804-675-7072
  • Fax: 804-675-0469
Mailing address:
  • Phone: 804-675-7072
  • Fax: 804-675-0469

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number579
License Number StateVA

VIII. Authorized Official

Name: DR. ALEAVELLE COX
Title or Position: DIRECTOR
Credential: PHD
Phone: 804-675-7072