Organization
COMMUNITY EMPOWERMENT PROGRAM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CLINTRAL TRIMELLE MORRIS (CEO)
(804) 266-3909
Entity
Organization
Contact information
Practice address
9545 KENNEDY STATION TER, GLEN ALLEN, VA 23060-3933
(809) 426-6390
(804) 266-3930
Mailing address
PO BOX 1186, 9545 KENNEDY STATION TERRACE, GLEN ALLEN, VA 23060-1186
(809) 426-6390
(804) 266-3930
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
SS-230-07
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010177162
DEPARTMENT OF MEDICAL ASSISTANCE SERVICES
VA
Enumeration date
04/23/2008
Last updated
04/23/2008
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