Jennifer White

Organization Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Disputanta, VA

NPI 1083137368 · NPPES record last updated Jul 21, 2022

Key facts

NPI
1083137368
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
Legal business name
JENNIFER WHITE
Practice address
6688 Tatum Road
Disputanta, VA 23842-6902
Phone
(804) 550-8674
NPI assigned
Jul 19, 2017
Organization subpart
No

Authorized official

Name
Jennifer Jayne White
Title
Billing
Phone
(804) 550-8674

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Yes

Addresses

Primary practice location

6688 Tatum Road
Disputanta, VA 23842-6902

Mailing address

6688 Tatum Rd
Disputanta, VA 23842-6902
Phone (804) 550-8674

Other practice location 1

6688 Tatum Road
Disputanta, VA 23842-6902
Phone (804) 550-8674

Other providers in Disputanta, VA

All providers in Disputanta, VA · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Virginia

Sources for this page

Verify at the official NPI Registry.