Interfaith Adult Day Care, Inc.

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

License

ADC14950036 Issued in VA

Legal business name

INTERFAITH ADULT DAY CARE, INC.

Practice address

201 Walnut Blvd
Petersburg, VA 23805-2025

Phone

(804) 732-3919

Fax

(804) 732-2163

NPI assigned

May 12, 2015

Organization subpart

No

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

Authorized official

Name

Ms. Jacqueline Delores Mealing, B.S.

Title

Executive Director

Phone

(804) 732-3919

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1431388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431388800000",
    "number": "1871971770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 WALNUT BLVD",
            "address_2": "P.O. BOX 3272",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238052025",
            "telephone_number": "804-732-3919",
            "fax_number": "804-732-2163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 WALNUT BLVD",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238052025",
            "telephone_number": "804-732-3919",
            "fax_number": "804-732-2163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERFAITH ADULT DAY CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-12",
        "last_updated": "2015-05-12",
        "status": "A",
        "authorized_official_last_name": "MEALING",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "DELORES",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "804-732-3919",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "B.S."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "VA",
            "license": "ADC14950036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Day Care Clinic/Center in Petersburg, VA
• Providers in Petersburg, VA by specialty
• Adult Day Care Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2015; 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.