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General NPI Number Information
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NPI Number | 1205581071
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Entity Type | Organization
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Legal Business Name | WINSTON'S RESIDENTIAL, LLC
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Dates
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Enumeration Date | 02/19/2022
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Last Update Date | 11/10/2022
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Provider Practice Location Address
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Address Line | 4813 PAWPANS CT
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23237-2115
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Country | US
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Telephone | 804-363-9879
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Fax |
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Provider Business Mailing Address
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Address Line | 14649 GRAND FOREST TER
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City | SOUTH CHESTERFIELD
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State | VA
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Zip | 23834-6827
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Country | US
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Telephone | 804-363-9879
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MRS. SONIA IVETTE WINSTON
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Credential | RN
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Telephone | 804-363-9879
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #3
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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 |
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License Number State |
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