Organization
WOODRUFF RESIDENTIAL LLC
Active
Organization
WOODRUFF RESIDENTIAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAVONNE RENEE JACKSON NP (DIRECTOR)
(804) 402-1894
Entity
Organization
Contact information
Practice address
9447 HILDA AVE, NORTH CHESTERFIELD, VA 23237-3440
(804) 402-1894
Mailing address
1924 WHITE MOUNTAIN DR, CHESTER, VA 23836-3008
(804) 402-1894
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
01/22/2025
Last updated
06/02/2025
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