OrganizationActive
Supportive Residential LLC
NPI 1962280727 · Day Training/Habilitation Specialist · Richmond, VA
Provider details
- NPI number
- 1962280727
- Entity type
- Organization
- Primary specialty
- Day Training/Habilitation SpecialistNursing Service Related Providers
- Organization subpart
- No
- Authorized official
- Ashley Clark, Executive Director(804) 305-4790
Specialties & taxonomies
Nursing Service Related Providers
Practice location
934 Pleasant St
Richmond, VA 23223-6190
Phone: (804) 305-4790
Approximate (ZIP-level) locationGet directions
Mailing address
8005 Reedy Branch Rd
Chesterfield, VA 23838-5710
Registry dates
- Enumerated
- 2023-09-21
- Last updated
- 2023-09-21
- Certified
- 2023-09-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.