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General NPI Number Information
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NPI Number | 1275245433
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Entity Type | Organization
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Legal Business Name | SEASONED ADULT DAY CARE, INC
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Dates
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Enumeration Date | 12/20/2022
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Last Update Date | 12/20/2022
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Provider Practice Location Address
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Address Line | 813 W NINE MILE RD
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City | HIGHLAND SPRINGS
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State | VA
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Zip | 23075-1124
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Country | US
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Telephone | 804-651-9254
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Fax |
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Provider Business Mailing Address
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Address Line | 1016 LESLIE ANN DR
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City | RICHMOND
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State | VA
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Zip | 23223-2208
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Country | US
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Telephone | 804-651-9254
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. CHARLES RAY BURLEY
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Credential |
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Telephone | 804-651-9254
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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