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Organization

INNER-VISION EDUCATION CENTER, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAMON PETERSON (OWNER)
(804) 794-1573
Entity
Organization

Contact information

Practice address
1572 STANDING RIDGE DR, POWHATAN, VA 23139-8051
(804) 794-1573
(804) 414-7026
Mailing address
1572 STANDING RIDGE DR, POWHATAN, VA 23139-8051
(804) 794-1573
(804) 414-7026

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
199102006
VA

Other

Enumeration date
02/11/2014
Last updated
02/11/2014
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