Organization
COMPANIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEON MICHAEL BRAXTON (OWNER)
(804) 273-0579
Entity
Organization
Contact information
Practice address
9300 GILDENFIELD CT, RICHMOND, VA 23294-5621
(804) 273-0579
(804) 527-5325
Mailing address
9300 GILDENFIELD CT, RICHMOND, VA 23294-5621
(804) 273-0579
(804) 527-5325
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
B09159000
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
231151738
—
VA
Enumeration date
09/25/2014
Last updated
09/25/2014
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