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Organization

UNITED SUPPORTIVE SERVICES OF VIRGINIA LLC

Active
Parent organization
GUARDIAN RESIDENTIAL SERVICES, INC
Organization subpart
Yes

Provider details

NPI number
Legal business name
GUARDIAN RESIDENTIAL SERVICES, INC
Authorized official
MR. JOHN THOMAS REDD III (CEO)
(804) 359-0613
Entity
Organization

Contact information

Practice address
1510 WILLOW LAWN DR, 100, RICHMOND, VA 23230-3429
(804) 359-0613
(804) 359-0614
Mailing address
1510 WILLOW LAWN DR, 100, RICHMOND, VA 23230-3429
(804) 359-0613
(804) 359-0614

Taxonomy

Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
229698
VA
251B00000X
Case Management Agency
Primary
229698
VA
253Z00000X
In Home Supportive Care Agency
229698
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
229698
VIRGINIA DEPARTMENT OF AGING AND REHABILITATIVE SERVICES
VA
Enumeration date
10/06/2014
Last updated
10/06/2014
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