Provider Demographics
NPI:1679687800
Name:HANOVER ADULT CENTER, INC
Entity Type:Organization
Organization Name:HANOVER ADULT CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:W
Authorized Official - Last Name:SHEPHERD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-746-0743
Mailing Address - Street 1:7231 STONEWALL PKWY
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23111-1110
Mailing Address - Country:US
Mailing Address - Phone:804-746-0743
Mailing Address - Fax:804-559-1139
Practice Address - Street 1:7231 STONEWALL PKWY
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23111-1110
Practice Address - Country:US
Practice Address - Phone:804-746-0743
Practice Address - Fax:804-559-1139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care