Organization
RIVER CITY RESIDENCES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONALD A. WALLACE (EXECUTIVE DIRECTOR)
(804) 307-6908
Entity
Organization
Contact information
Practice address
10201 DURYEA DR, RICHMOND, VA 23235-1705
(804) 323-5959
(804) 323-5959
Mailing address
10201 DURYEA DR, RICHMOND, VA 23235-1705
(804) 323-5959
(804) 323-5959
Taxonomy
Speciality
Code
Description
License number
State
310500000X
Mental Illness Intermediate Care Facility
911-01001
VA
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
911-01001
VA
Other
Enumeration date
12/06/2007
Last updated
12/06/2007
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