Provider Demographics
NPI:1699812404
Name:GREATER UNITY ADULT SERVICES
Entity Type:Organization
Organization Name:GREATER UNITY ADULT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:804-622-6213
Mailing Address - Street 1:4240 BONNIEBANK RD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23234-6602
Mailing Address - Country:US
Mailing Address - Phone:804-986-7900
Mailing Address - Fax:
Practice Address - Street 1:4240 BONNIEBANK RD
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23234-6602
Practice Address - Country:US
Practice Address - Phone:804-986-7900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1699812404Medicaid