Organization
COMPASSIONATE CARE DAY SUPPORT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE DELORES JOHNSON BSN RN (OWNER)
(804) 255-6777
Entity
Organization
Contact information
Practice address
700 S SYCAMORE ST STE 5, PETERSBURG, VA 23803-5804
(804) 255-6777
Mailing address
700 S SYCAMORE ST STE 5, PETERSBURG, VA 23803-5804
(804) 255-6777
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
—
—
Other
Enumeration date
02/26/2025
Last updated
02/26/2025
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