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General NPI Number Information
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NPI Number | 1366100331
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Entity Type | Organization
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Legal Business Name | THE LEARNING GROVE ACADEMIC & ARTS ENRICHMENT FOR CHILDREN
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Dates
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Enumeration Date | 12/07/2021
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Last Update Date | 12/07/2021
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Provider Practice Location Address
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Address Line | 11103 INGALLSTON RD
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City | HENRICO
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State | VA
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Zip | 23233-2212
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Country | US
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Telephone | 804-714-5576
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Fax |
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Provider Business Mailing Address
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Address Line | 11103 INGALLSTON RD
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City | HENRICO
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State | VA
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Zip | 23233-2212
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Country | US
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Telephone | 804-714-5576
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Fax |
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Authorized Official
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Title or Position | CHIEF CREATIVE OPERATOR
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Name | MRS. SABRINA MORGAN JORDAN
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Credential | RBT
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Telephone | 804-714-5576
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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