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General NPI Number Information
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NPI Number | 1215102785
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Entity Type | Organization
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Legal Business Name | POWR, INC.
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Dates
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Enumeration Date | 04/25/2008
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Last Update Date | 04/25/2008
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Provider Practice Location Address
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Address Line | 6300 WHISTLER RD
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City | RICHMOND
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State | VA
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Zip | 23227-1606
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Country | US
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Telephone | 804-515-8017
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Fax | 804-515-7513
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Provider Business Mailing Address
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Address Line | PO BOX 15454
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City | RICHMOND
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State | VA
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Zip | 23227-5454
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Country | US
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Telephone | 804-515-8017
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Fax | 804-515-7513
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Authorized Official
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Title or Position | CEO
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Name | MR. DERMAN D SPRAGG SR.
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Credential |
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Telephone | 804-515-8017
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | 88-259-46
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License Number State | VA
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