Raven's Nest LLC
NPI #1053721381 in Chase City, Virginia
Provider Information
- NPI Number
- 1053721381
- Entity Type
- Organization
- Organization Name
- Raven's Nest LLC
- Primary Specialty
- Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Enumeration Date
- May 8, 2014
- Last Updated
- May 8, 2014
Practice Location
- Address
- 1247 FORT MITCHELL DR
- City
- Chase City
- State
- Virginia
- ZIP Code
- 23924-5340
- Phone
- (434) 738-8493
Authorized Official
- Name
- RAVEN JACKSON, M.S.
- Title
- DIRECTOR
- Phone
- (434) 210-0343
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
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