Individual
CHARLES SMALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10712 TOSTON LN, GLEN ALLEN, VA 23060-6496
(804) 252-5482
(804) 252-5482
Mailing address
10712 TOSTON LN, GLEN ALLEN, VA 23060-6496
(804) 252-5482
(804) 252-5482
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
16459-08-013
VA
Other
Enumeration date
02/04/2026
Last updated
02/04/2026
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