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General NPI Number Information
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NPI Number | 1205118064
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Entity Type | Organization
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Legal Business Name | DEUTERONOMY EIGHT EIGHTEEN LLC
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Dates
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Enumeration Date | 09/16/2011
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Last Update Date | 09/16/2011
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Provider Practice Location Address
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Address Line | 6540 MONAHAN RD
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City | RICHMOND
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State | VA
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Zip | 23231-6019
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Country | US
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Telephone | 804-252-9391
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Fax |
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Provider Business Mailing Address
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Address Line | 6540 MONAHAN RD
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City | RICHMOND
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State | VA
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Zip | 23231-6019
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Country | US
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Telephone | 804-252-9391
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. AMINATA WILLIAMS
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Credential | M.S.
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Telephone | 804-252-9391
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | 1363
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License Number State | VA
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