Organization
INDEPENDENT FAMILY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLEVELAND THOMAS WALKER SR. (CEO)
(804) 451-9935
Entity
Organization
Contact information
Practice address
1953 COGGIN ST, PETERSBURG, VA 23805-2009
(804) 451-9935
(804) 504-5573
Mailing address
1953 COGGIN ST, PETERSBURG, VA 23805-2009
(804) 451-9935
(804) 504-5573
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
2016
VA
Other
Enumeration date
08/20/2013
Last updated
08/20/2013
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