Organization
RANDOLPH & DAVISON ENTERPRISES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NITA VIANN RANDOLPH DAVISON (CEO)
(804) 605-9845
Entity
Organization
Contact information
Practice address
6421 BELMONT RD, CHESTERFIELD, VA 23832-8213
(804) 605-9845
(804) 895-7853
Mailing address
1889 S SYCAMORE ST, PETERSBURG, VA 23805-2730
(804) 605-9845
(804) 895-7853
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/14/2023
Last updated
11/14/2023
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