Organization
CLEARR VISSION SUPPORT SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DERWIN LAMONT HICKMAN SR. (CEO)
(804) 527-0992
Entity
Organization
Contact information
Practice address
5812 NORTHFORD PL, CHESTERFIELD, VA 23832-7590
(804) 271-7263
(804) 271-8612
Mailing address
7818 CAMOLIN CT, RICHMOND, VA 23228-6400
(804) 527-0992
(804) 271-8612
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
VA
Other
Enumeration date
10/20/2006
Last updated
08/22/2020
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