OrganizationActive
Community Wellness & Support, LLC
NPI 1740766161 · Substance Abuse Rehabilitation Facility · Petersburg, VA
Provider details
- NPI number
- 1740766161
- Entity type
- Organization
- Primary specialty
- Substance Abuse Rehabilitation FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Clarence Harris, Director of Services(804) 909-2891
Specialties & taxonomies
Residential Treatment Facilities
Practice location
34 Medical Park Blvd Ste a
Petersburg, VA 23805-9283
Phone: (804) 909-2891
Fax: (804) 441-9089
Approximate (ZIP-level) locationGet directions
Mailing address
34 Medical Park Blvd Ste a
Petersburg, VA 23805-9283
Registry dates
- Enumerated
- 2018-07-18
- Last updated
- 2018-07-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.