Organization
AZAREL COMMUNITY SUPPORT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TACOLA WHITING (OWNER)
(804) 928-3054
Entity
Organization
Contact information
Practice address
112 BRANDON RD, RICHMOND, VA 23224-1212
(804) 928-3054
(804) 231-6129
Mailing address
112 BRANDON RD, RICHMOND, VA 23224-1212
(804) 928-3054
(804) 231-6129
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2920
VIRGINIA DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES
VA
Enumeration date
11/05/2019
Last updated
11/05/2019
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