Organization
KERY ANN ROSETTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TA-VON Y'VETTE BECKER (CEO)
(804) 310-1835
Entity
Organization
Contact information
Practice address
5818 HEATHERS CROSSING DR, CHESTERFIELD, VA 23832-8493
(804) 310-1835
Mailing address
5818 HEATHERS CROSSING DR, CHESTERFIELD, VA 23832-8493
(804) 310-1835
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/07/2020
Last updated
01/10/2024
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