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Organization
DREAM 9D GROUP HOME LLC
Active
Organization
DREAM 9D GROUP HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DESTANEY LASHAY STARKE (CEO)
(804) 919-1180
Entity
Organization
Contact information
Practice address
817 S JONES ST, PETERSBURG, VA 23803-4952
(804) 919-1180
Mailing address
817 S JONES ST, PETERSBURG, VA 23803-4952
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
NULL
Other
Enumeration date
09/29/2014
Last updated
09/29/2014
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