Organization
SUPREME CARE DKS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATRINA S SAMUELS (OWNER)
(804) 687-9427
Entity
Organization
Contact information
Practice address
3903 GENACRE LN, RICHMOND, VA 23222-1731
(804) 687-9427
(804) 486-6620
Mailing address
3903 GENACRE LN, RICHMOND, VA 23222-1731
(804) 687-9427
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/31/2024
Last updated
12/31/2024
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