Organization
FULL POCKET FARM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GAYLE D DILLON M.ED, QDDP (EXECUTIVE DIRECTOR)
(804) 366-4815
Entity
Organization
Contact information
Practice address
15094 HAWKS CLIMB LN, MONTPELIER, VA 23192-2706
(804) 366-4815
(804) 366-4815
Mailing address
15094 HAWKS CLIMB LN, MONTPELIER, VA 23192-2706
(804) 366-4815
(804) 366-4815
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
10/31/2018
Last updated
10/31/2018
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