Organization
INFINITE POTENTIAL SUPPORTIVE SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. HEATHER L MURPHY (DIRECTER/OWNER)
(276) 523-2797
Entity
Organization
Contact information
Practice address
2114 AVON STREET, EAST STONE GAP, VA 24246
(276) 523-2797
(276) 523-2797
Mailing address
PO BOX 390, 2114 AVON STREET, EAST STONE GAP, VA 24246-0390
(276) 523-2797
(276) 523-2797
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
1213
VA
Other
Enumeration date
04/05/2010
Last updated
04/05/2010
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