Organization
LOTTIE-ESTELLE GROUP HOME, INC
Active
Other names
United Steps Day Support
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TIFFANY TILLERSON TERRY (QMRP)
(434) 372-0407
Entity
Organization
Contact information
Practice address
4897 HWY 47, CHASE CITY, VA 23924-3606
(434) 372-0407
(434) 372-0394
Mailing address
4883 HWY 47, CHASE CITY, VA 23924-3606
(434) 372-0407
(434) 372-0394
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
808
VA
Other
Enumeration date
10/09/2013
Last updated
10/09/2013
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