NPI 1962280727
Supportive Residential LLC
Practice location
- Address
- 934 Pleasant St, Richmond, VA 23223-6190
- Phone
- (804) 305-4790
- Mailing address
- 8005 Reedy Branch Rd, Chesterfield, VA 23838-5710
Authorised official
- Name
- Ashley Renee Clark
- Title
- Executive Director
- Phone
- (804) 305-4790
Registered specialties
Day Training/Habilitation Specialist
Primary
Registry record
- NPI
- 1962280727
- Entity type
- Organization
- NPI issued
- 21 Sep 2023
- Record last updated
- 21 Sep 2023
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.