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General NPI Number Information
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NPI Number | 1245140409
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Entity Type | Organization
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Legal Business Name | MARY'S REST HOME FOR ADULTS INC.
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Dates
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Enumeration Date | 09/10/2026
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Last Update Date | 09/10/2026
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Provider Practice Location Address
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Address Line | 10519 FRANCISCO RD
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City | FARMVILLE
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State | VA
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Zip | 23901-7068
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Country | US
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Telephone | 434-574-6271
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Fax | 434-574-6274
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Provider Business Mailing Address
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Address Line | 10519 FRANCISCO RD
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City | FARMVILLE
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State | VA
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Zip | 23901-7068
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Country | US
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Telephone | 434-574-6271
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Fax | 434-574-6274
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | MS. LATOYA GRAY
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Credential |
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Telephone | 434-574-6271
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training 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 | 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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