Provider Demographics
NPI:1396113056
Name:DENISE ELAINE DEMERY
Entity type:Organization
Organization Name:DENISE ELAINE DEMERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SERVICE FACILITATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:DEMERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-564-2304
Mailing Address - Street 1:1723 HUNGARY RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23228-2352
Mailing Address - Country:US
Mailing Address - Phone:804-564-2304
Mailing Address - Fax:804-564-2304
Practice Address - Street 1:1723 HUNGARY RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23228-2352
Practice Address - Country:US
Practice Address - Phone:804-564-2304
Practice Address - Fax:804-564-2304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-10
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management