The Club House of Virginia, Inc.

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

THE CLUB HOUSE OF VIRGINIA, INC.

Practice address

2221 E Parham Rd Ste a
Henrico, VA 23228-2239

Phone

(804) 721-3073

NPI assigned

Jul 15, 2024

Organization subpart

No

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

Authorized official

Name

Ruben C Gracia

Title

Owner

Phone

(804) 721-3073

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1721001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721001600000",
    "number": "1184461204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12501 CHESDIN LANDING DR",
            "city": "CHESTERFIELD",
            "state": "VA",
            "postal_code": "238383230",
            "telephone_number": "804-721-3073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2221 E PARHAM RD STE A",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232282239",
            "telephone_number": "804-721-3073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CLUB HOUSE OF VIRGINIA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-15",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A",
        "authorized_official_last_name": "GRACIA",
        "authorized_official_first_name": "RUBEN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "804-721-3073"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Developmentally Disabled Services Day Training Agency in Henrico, VA
• Providers in Henrico, VA by specialty
• Developmentally Disabled Services Day Training Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; 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.