Provider Demographics
NPI:1962637678
Name:WE CARE RESIDENTIAL, LLC
Entity Type:Organization
Organization Name:WE CARE RESIDENTIAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DARYL
Authorized Official - Middle Name:A
Authorized Official - Last Name:JEFFERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-523-7702
Mailing Address - Street 1:108 STERLING FOREST PKWY
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23227-1677
Mailing Address - Country:US
Mailing Address - Phone:804-523-7702
Mailing Address - Fax:866-383-5281
Practice Address - Street 1:2317 WESTWOOD AVE
Practice Address - Street 2:SUITE 209
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-4007
Practice Address - Country:US
Practice Address - Phone:804-523-7702
Practice Address - Fax:866-383-5281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-26
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities