Organization
PEDEREC SUPPORTED LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEROLINE FAI BSN (CLINICAL MANAGER)
(571) 327-7252
Entity
Organization
Contact information
Practice address
14115 LOVERS LN STE 120, CULPEPER, VA 22701-4157
(571) 237-7725
(757) 935-0240
Mailing address
14115 LOVERS LN STE 120, CULPEPER, VA 22701-4157
(571) 237-7725
(757) 935-0240
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/07/2025
Last updated
11/07/2025
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