| Compassionate Care Day Support Llc | |
|
700 S Sycamore St Ste 5 Petersburg VA 23803-5804 | |
| (804) 255-6777 | |
| Not Available |
| Full Name | Compassionate Care Day Support Llc |
|---|---|
| Speciality | Psychologist - Intellectual & Developmental Disabilities |
| Location | 700 S Sycamore St Ste 5, Petersburg, Virginia |
| Authorized Official Name and Position | Diane Delores Johnson (OWNER) |
| Authorized Official Contact | 8042556777 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Compassionate Care Day Support Llc 700 S Sycamore St Ste 5 Petersburg VA 23803-5804 Ph: (804) 255-6777 | Compassionate Care Day Support Llc 700 S Sycamore St Ste 5 Petersburg VA 23803-5804 Ph: (804) 255-6777 |
| NPI Number | 1043017353 |
|---|---|
| Provider Enumeration Date | 02/26/2025 |
| Last Update Date | 02/26/2025 |
| Certification Date | 02/25/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043017353 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TM1800X | Psychologist - Intellectual & Developmental Disabilities | (* (Not Available)) | Primary |
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