NPI 1366629610

Wise Enterprise, Incorporated

Organisation PACE Provider Organization Richmond, VA

Practice location

Address: 4895 Burnham Rd, Richmond, VA 23234-3711
Phone: (804) 986-8214
Mailing address: 3109 W Clay St, Richmond, VA 23230-4703

Authorised official

Name: Gwendolyn Veronica Andrews
Title: Chief Executive Officer
Phone: (804) 986-8214

Registered specialties

PACE Provider Organization Primary

Agencies Taxonomy 251T00000X Licence 973-02-029 (VA)

Other Program of All-Inclusive Care for the Elderly (PACE) Provider Organization providers in Virginia →

Registry record

NPI: 1366629610
Entity type: Organization
NPI issued: 29 Jan 2008
Record last updated: 29 Jan 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.