Organization
COMMONWEALTH DAY SUPPORT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERRY RAWLINSON (EXECUTIVE DIRECTOR)
(804) 908-4635
Entity
Organization
Contact information
Practice address
500 S SYCAMORE ST, PETERSBURG, VA 23803-5046
(804) 908-4635
Mailing address
5601 HULL STREET RD, RICHMOND, VA 23224-2839
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
2076
VA
Other
Enumeration date
05/04/2017
Last updated
05/04/2017
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