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General NPI Number Information
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NPI Number | 1740774033
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Entity Type | Organization
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Legal Business Name | ASCEND HEALTH ADULT RETREAT, LLC
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Dates
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Enumeration Date | 06/19/2018
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Last Update Date | 07/21/2025
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Provider Practice Location Address
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Address Line | 6421 CHESTERFIELD MEADOWS DR
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City | CHESTERFIELD
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State | VA
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Zip | 23832-8810
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Country | US
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Telephone | 804-621-4209
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4101
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City | MIDLOTHIAN
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State | VA
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Zip | 23112-0002
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Country | US
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Telephone | 804-621-4209
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Fax | 800-425-4412
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Authorized Official
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Title or Position | DIRECTOR/OWNER
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Name | PHONYA LEWIS
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Credential |
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Telephone | 804-641-0952
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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