MEDICARE: BLACK DOT COMMUNITY SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1891651782
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLACK DOT COMMUNITY SERVICES LLC

Provider Business Mailing Address
First Line	:	1140 OLD MAYFIELD RD
Second Line	:
City	:	DANVILLE
State	:	VA
Zip	:	24541-7500
Country	:	US
Telephone Number	:	336-380-4813
Fax Number	:

Provider Business Practice Location Address
First Line	:	1140 OLD MAYFIELD RD
Second Line	:
City	:	DANVILLE
State	:	VA
Zip	:	24541-7500
Country	:	US
Telephone Number	:	336-380-4813
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SHEMIA LATRIEACE GARNER
Credential	:	RN
Telephone Number	:	336-380-4813

Provider Enumeration Date	:	01/05/2026
Last Update Date	:	01/05/2026

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Directions to “BLACK DOT COMMUNITY SERVICES LLC ” Practice Location

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