Organization
SOUTHERN LIVING CHILD CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER J WHITE MEMBER (MEMBER)
(804) 550-8674
Entity
Organization
Contact information
Practice address
6688 TATUM RD, DISPUTANTA, VA 23842-6902
(804) 550-8674
Mailing address
6688 TATUM RD, DISPUTANTA, VA 23842-6902
(804) 550-8674
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/21/2014
Last updated
11/21/2014
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