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General NPI Number Information
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NPI Number | 1912882119
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Entity Type | Organization
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Legal Business Name | PIEDMONT SUPPORT LLC
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Dates
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Enumeration Date | 08/07/2025
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 633 NEWTON ST
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City | DANVILLE
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State | VA
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Zip | 24541-2019
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Country | US
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Telephone | 434-425-2928
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Fax |
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Provider Business Mailing Address
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Address Line | 737 VICAR RD
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City | DANVILLE
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State | VA
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Zip | 24540-1269
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Country | US
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Telephone | 434-227-0948
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Fax |
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Authorized Official
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Title or Position | SERVICE DIRECTOR
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Name | TORY FITZGERALD
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Credential |
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Telephone | 434-227-0948
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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 |
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License Number State |
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