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General NPI Number Information
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NPI Number | 1578896171
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Entity Type | Organization
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Legal Business Name | REST ASSURED LLC
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Dates
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Enumeration Date | 09/14/2009
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Last Update Date | 09/14/2009
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Provider Practice Location Address
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Address Line | 3830 MONZA DR
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City | RICHMOND
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State | VA
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Zip | 23234-4214
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Country | US
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Telephone | 804-279-9347
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Fax |
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Provider Business Mailing Address
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Address Line | 4003 COLLINGBOURNE RD
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City | RICHMOND
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State | VA
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Zip | 23235-1521
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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 | CAO
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Name | MRS. CHERODNICKER T BROWN
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Credential | MA
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Telephone | 804-267-3565
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | 126614001
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License Number State | VA
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