OrganizationActive
An Extension of Our Family,llc
NPI 1083322457 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Midlothian, VA
Provider details
- NPI number
- 1083322457
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Deangelo Rives, Manager(804) 479-5761
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000X
Residential Treatment Facilities
Practice location
14810 Acorn Ridge Rd
Midlothian, VA 23112-2302
Phone: (804) 479-5761
Approximate (ZIP-level) locationGet directions
Mailing address
14810 Acorn Ridge Rd
Midlothian, VA 23112-2302
Registry dates
- Enumerated
- 2022-11-14
- Last updated
- 2022-11-14
- Certified
- 2022-11-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.