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General NPI Number Information
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NPI Number | 1548493125
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Entity Type | Organization
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Legal Business Name | NEW DIRECTIONS COMMUNITY OUTREACH SERVICES LLC
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Dates
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Enumeration Date | 08/28/2009
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Last Update Date | 08/28/2009
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Provider Practice Location Address
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Address Line | 3117 W CLAY ST SUITE 2, 3, 4 AND 5
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City | RICHMOND
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State | VA
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Zip | 23230-4731
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Country | US
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Telephone | 804-447-8419
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Fax | 804-447-8424
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Provider Business Mailing Address
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Address Line | 3117 W CLAY ST SUITE 2, 3, 4 AND 5
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City | RICHMOND
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State | VA
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Zip | 23230-4731
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Country | US
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Telephone | 804-447-8419
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Fax | 804-447-8424
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MR. COREY GILPIN
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Credential |
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Telephone | 804-447-8424
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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 | 1313-05-001
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License Number State | VA
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