Organization
RAE'S HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRISTINE CARBURY (PRESIDENT)
(804) 855-8641
Entity
Organization
Contact information
Practice address
8700 S BOONES TRAIL RD, NORTH CHESTERFIELD, VA 23236-4735
(804) 855-8641
Mailing address
8700 S BOONES TRAIL RD, NORTH CHESTERFIELD, VA 23236-4735
(804) 855-8641
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
09/10/2024
Last updated
08/04/2025
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