Organization
BREAD OF LIFE SOLUTIONS LLC
Active
Other names
Bread of Life Residential Services
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHAUNTAE CYRILLE BSN,RN (OWNER)
(804) 651-0473
Entity
Organization
Contact information
Practice address
2947 BRIERWOOD RD, PETERSBURG, VA 23805-2946
(804) 651-0473
Mailing address
6507 WHISPERWOOD DR, NORTH CHESTERFIELD, VA 23234-6289
(804) 381-0732
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
—
174200000X
Meals Provider
—
—
177F00000X
Lodging Provider
—
—
251B00000X
Case Management Agency
—
—
251J00000X
Nursing Care Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
03/27/2024
Last updated
03/27/2024
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