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General NPI Number Information
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NPI Number | 1063225217
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Entity Type | Organization
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Legal Business Name | GREATER GIFT RESIDENTIAL LLC
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Dates
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Enumeration Date | 01/30/2025
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 105 S HOLLY AVE
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City | HENRICO
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State | VA
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Zip | 23075-1332
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Country | US
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Telephone | 804-605-7505
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Fax |
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Provider Business Mailing Address
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Address Line | 1116 DOMINION TOWNES PL
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City | RICHMOND
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State | VA
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Zip | 23223-2281
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Country | US
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Telephone | 804-605-7505
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DAJAUN CALVIN
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Credential |
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Telephone | 804-605-7505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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