Organization
THE CLUB HOUSE OF VIRGINIA, INC.
Active
Organization
THE CLUB HOUSE OF VIRGINIA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUBEN C GRACIA (OWNER)
(804) 721-3073
Entity
Organization
Contact information
Practice address
2221 E PARHAM RD STE A, HENRICO, VA 23228-2239
(804) 721-3073
Mailing address
12501 CHESDIN LANDING DR, CHESTERFIELD, VA 23838-3230
(804) 721-3073
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
07/15/2024
Last updated
07/15/2024
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