Organization
GREATER WILLIAMSBURG RESIDENTIAL FACILITY, LP.
Active
Parent organization
DESTINYS HOUSE RESIDENTIAL SERVICES, LLC.
Other names
Greater Williamsburg Residential Facility
Organization subpart
Yes
Provider details
NPI number
Legal business name
DESTINYS HOUSE RESIDENTIAL SERVICES, LLC.
Authorized official
PATRICE MUHAMMAD (EXECUTIVE DIRECTOR)
(757) 903-4236
Entity
Organization
Contact information
Practice address
602 TAM O SHANTER BLVD, WILLIAMSBURG, VA 23185-5922
(757) 903-4236
Mailing address
602 TAM O SHANTER BLVD, WILLIAMSBURG, VA 23185-5922
(757) 903-4236
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
990
VA
Other
Enumeration date
01/29/2010
Last updated
01/29/2010
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