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General NPI Number Information
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NPI Number | 1609982032
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Entity Type | Organization
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Legal Business Name | VIABLE ADULT DAY CARE CENTER
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 10/25/2013
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Provider Practice Location Address
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Address Line | 4501 WILLIAMSBURG RD SUITE P
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City | RICHMOND
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State | VA
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Zip | 23231-2700
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Country | US
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Telephone | 804-222-3355
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Fax | 804-222-3917
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Provider Business Mailing Address
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Address Line | 4501 WILLIAMSBURG RD SUITE P
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City | RICHMOND
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State | VA
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Zip | 23231-2700
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Country | US
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Telephone | 804-222-3355
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Fax | 804-222-3917
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. GLORIA N ELLIOTTE
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Credential | RN
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Telephone | 804-222-3355
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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 | CLO-06-338
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License Number State | VA
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