Organization
PREAVIC SIGNATURE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARGARET A DARAMOLA REGISTERED NURSE (CEO)
(804) 503-8979
Entity
Organization
Contact information
Practice address
4317 LAUREL OAK RD, NORTH CHESTERFIELD, VA 23237-4312
(804) 503-8979
Mailing address
4301 BEULAH OAKS CIR, NORTH CHESTERFIELD, VA 23234-6281
(804) 503-8979
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/11/2021
Last updated
08/11/2021
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