Organization
LOVE & LIGHT HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DE'BRYANT MABRY SR. (OWNER)
(804) 892-2134
Entity
Organization
Contact information
Practice address
4401 WIDGEON CT, NORTH DINWIDDIE, VA 23803-6883
(804) 504-5483
(804) 203-4916
Mailing address
4401 WIDGEON CT, NORTH DINWIDDIE, VA 23803-6883
(804) 504-5483
(804) 203-4916
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
09/10/2021
Last updated
11/02/2021
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