Den of Epiphanies, LLC

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

DEN OF EPIPHANIES, LLC

Practice address

4009 Moss Point Drive
Petersburg, VA 23803

Phone

(904) 301-8931

NPI assigned

Apr 28, 2026

Last updated

Apr 28, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sherece Bruce

Title

Owner

Phone

(804) 301-8931

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1777334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777334400000",
    "number": "1215873310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4009 MOSS POINT DRIVE",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "23803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4009 MOSS POINT DRIVE",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "23803",
            "telephone_number": "904-301-8931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEN OF EPIPHANIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-28",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A",
        "authorized_official_last_name": "BRUCE",
        "authorized_official_first_name": "SHERECE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "804-301-8931"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "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 Residential Treatment Facility in Petersburg, VA
• Providers in Petersburg, VA by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2026; 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.