Live Impact Day Support

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

License

1093-02-006 Issued in VA

Legal business name

LIVE IMPACT DAY SUPPORT

Practice address

7200 Beach Rd
Chesterfield, VA 23838-6505

Phone

(804) 814-4845

Fax

(804) 276-2536

NPI assigned

Jan 9, 2014

Organization subpart

Yes

Parent organization

COMPASSIONATE HEARTS FAMILY SERVICES, INC.As reported in NPPES

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

Authorized official

Name

Mrs. Bridget Olugbemi

Title

Ceo/Program Director

Phone

(804) 814-4845

Specialties & licenses 1

Addresses

Part of

Live Impact Day Support

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

{
    "created_epoch": "1389225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389225600000",
    "number": "1437571536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4667",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231120011",
            "telephone_number": "804-814-4845",
            "fax_number": "804-276-2536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7200 BEACH RD",
            "city": "CHESTERFIELD",
            "state": "VA",
            "postal_code": "238386505",
            "telephone_number": "804-814-4845",
            "fax_number": "804-276-2536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVE IMPACT DAY SUPPORT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMPASSIONATE HEARTS FAMILY SERVICES, INC.",
        "enumeration_date": "2014-01-09",
        "last_updated": "2014-01-09",
        "status": "A",
        "authorized_official_last_name": "OLUGBEMI",
        "authorized_official_first_name": "BRIDGET",
        "authorized_official_title_or_position": "CEO/PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "804-814-4845",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "VA",
            "license": "1093-02-006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Developmentally Disabled Services Day Training Agency in Chesterfield, VA
• Providers in Chesterfield, 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 Jan 9, 2014; 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.