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General NPI Number Information
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NPI Number | 1184946113
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Entity Type | Organization
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Legal Business Name | VICTORIA RESIDENTIAL SERVICES
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Dates
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Enumeration Date | 02/18/2010
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Last Update Date | 02/18/2010
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Provider Practice Location Address
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Address Line | 5919 WARWICK RD
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City | RICHMOND
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State | VA
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Zip | 23224-1446
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Country | US
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Telephone | 804-276-6477
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Fax | 804-276-6477
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Provider Business Mailing Address
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Address Line | 5919 WARWICK RD
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City | RICHMOND
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State | VA
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Zip | 23224-1446
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Country | US
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Telephone | 804-276-6477
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Fax | 804-276-6477
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Authorized Official
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Title or Position | ADMINISTRATIVE DIRECTOR
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Name | MRS. OLUSOLA VICTORIA AKINKUADE
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Credential |
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Telephone | 804-502-6187
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number | 876
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License Number State | VA
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