Spring Garden Residential Living, LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

SPRING GARDEN RESIDENTIAL LIVING, LLC

Practice address

20401 Halloway Ave
South Chesterfield, VA 23803-6409

Phone

(804) 721-9101

NPI assigned

Jun 16, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Alfred Taylor

Title

Administrator

Phone

(804) 721-9101

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1655337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655337600000",
    "number": "1134859697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23008 PHEASANT CT",
            "city": "NORTH DINWIDDIE",
            "state": "VA",
            "postal_code": "238038354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20401 HALLOWAY AVE",
            "city": "SOUTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "238036409",
            "telephone_number": "804-721-9101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRING GARDEN RESIDENTIAL LIVING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-16",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-11",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "ALFRED",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "804-721-9101"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in South Chesterfield, VA
• Providers in South Chesterfield, VA by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.