Provider Demographics
NPI:1669854220
Name:SWIFT CREEK DAY CENTER, LLC
Entity Type:Organization
Organization Name:SWIFT CREEK DAY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:
Authorized Official - Last Name:RAWLINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-744-7412
Mailing Address - Street 1:2806 FOX CHASE LN
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-4008
Mailing Address - Country:US
Mailing Address - Phone:804-744-7653
Mailing Address - Fax:
Practice Address - Street 1:2806 FOX CHASE LN
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-4008
Practice Address - Country:US
Practice Address - Phone:804-744-7653
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-19
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAADC14-1103676261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0158637147Medicaid