Organization
TRIUMPH RESIDENTIAL SERVICES, LLC
Active
Parent organization
TRIUMPH RESIDENTIAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
TRIUMPH RESIDENTIAL
Authorized official
LASHANDA POWELL (EXECUTIVE DIRECTOR)
(804) 520-0100
Entity
Organization
Contact information
Practice address
16067 CONTINENTAL BLVD, SOUTH CHESTERFIELD, VA 23834-5900
(804) 520-0100
Mailing address
16067 CONTINENTAL BLVD, SOUTH CHESTERFIELD, VA 23834-5900
(804) 520-0100
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
927-02-006
VA
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
927-02-001
VA
Other
Enumeration date
02/02/2015
Last updated
02/02/2015
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