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General NPI Number Information
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NPI Number | 1831286806
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Entity Type | Organization
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Legal Business Name | SISTER'S PLACE GROUP HOME II
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Dates
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Enumeration Date | 10/09/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 10204 SPINNING WHEEL WAY
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City | RICHMOND
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State | VA
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Zip | 23233-2750
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Country | US
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Telephone | 804-290-0216
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Fax | 804-290-0427
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Provider Business Mailing Address
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Address Line | 10204 SPINNING WHEEL WAY
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City | RICHMOND
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State | VA
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Zip | 23233-2750
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Country | US
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Telephone | 804-290-0216
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Fax | 804-290-0427
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Authorized Official
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Title or Position | CEO
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Name | MRS. DEBORAH MALONE RALPH
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Credential | L.C.S.W.
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Telephone | 804-290-0216
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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 | 287-2006
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License Number State | VA
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