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Organization

WISE ENTERPRISE, INCORPORATED

Active
Other names
Wise Enterprise, Incorporated
Organization subpart
No

Provider details

NPI number
Authorized official
MS. GWENDOLYN VERONICA ANDREWS M.S.W. (CHIEF EXECUTIVE OFFICER)
(804) 986-8214
Entity
Organization

Contact information

Practice address
4895 BURNHAM RD, RICHMOND, VA 23234-3711
(804) 986-8214
Mailing address
3109 W CLAY ST, RICHMOND, VA 23230-4703
(804) 301-3513

Taxonomy

Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
973-02-029
VA

Other

Enumeration date
01/29/2008
Last updated
01/29/2008
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