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Organization

DEN OF EPIPHANIES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SHERECE BRUCE (OWNER)
(804) 301-8931
Entity
Organization

Contact information

Practice address
4009 MOSS POINT DRIVE, PETERSBURG, VA 23803
(904) 301-8931
Mailing address
4009 MOSS POINT DRIVE, PETERSBURG, VA 23803

Taxonomy

Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary

Other

Enumeration date
04/28/2026
Last updated
04/28/2026
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