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General NPI Number Information
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NPI Number | 1497668008
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Entity Type | Organization
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Legal Business Name | SALT & LIGHT
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Dates
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Enumeration Date | 09/24/2026
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Last Update Date | 09/24/2026
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Provider Practice Location Address
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Address Line | 8401 MAYLAND DR # 10968
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City | RICHMOND
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State | VA
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Zip | 23294-4648
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Country | US
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Telephone | 804-585-1185
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Fax |
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Provider Business Mailing Address
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Address Line | 8401 MAYLAND DR # 10968
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City | RICHMOND
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State | VA
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Zip | 23294-4648
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | TAMI DOUGLASS
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Credential | LPN
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Telephone | 804-585-1185
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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