Providing Ease Residential Services

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

NPI 1306559596 · NPPES record last updated Jan 3, 2023

Key facts

NPI
1306559596
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
Legal business name
PROVIDING EASE RESIDENTIAL SERVICES
Practice address
218 Locust Dr
Waverly, VA 23890-5027
Phone
(804) 590-5706
NPI assigned
Jan 3, 2023
Organization subpart
No

Authorized official

Name
Sherita Johnson
Title
Owner
Phone
(804) 590-5706

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

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

Addresses

Primary practice location

218 Locust Dr
Waverly, VA 23890-5027

Mailing address

218 Locust Dr
Waverly, VA 23890-5027
Phone (804) 590-5706

Other identifiers

IdentifierTypeStateIssuer
2MedicaidVA

Other providers in Waverly, VA

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

Sources for this page

Verify at the official NPI Registry.