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Organization

JENNIFER WHITE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JENNIFER JAYNE WHITE (BILLING)
(804) 550-8674
Entity
Organization

Contact information

Practice address
6688 TATUM ROAD, DISPUTANTA, VA 23842-6902
(804) 550-8674
Mailing address
6688 TATUM RD, DISPUTANTA, VA 23842-6902
(804) 550-8674

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary

Other

Enumeration date
07/19/2017
Last updated
07/21/2022
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