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1477254894
GENESIS REIGN SUPPORT SERVICES LLC
NORTH CHESTERFIELD, VA
NPI
1477254894
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Entity Type
Organization
Authorized Contact
DERRICK DWAIN JACK
Owner
804-926-3696
Organization Subpart ?
No
Primary Taxonomy
251S00000X Community/Behavioral Health
Enumeration Date
2023-03-13
Last Update Date
2023-10-11
Business Address
GENESIS REIGN SUPPORT SERVICES LLC
6406 BAREBACK TER
NORTH CHESTERFIELD, VA 23234-4195
Phone number: 804-926-3696
Copy
Mailing Address
GENESIS REIGN SUPPORT SERVICES LLC
6406 BAREBACK TER
NORTH CHESTERFIELD, VA 23234-4195
Phone number: 804-926-3696
Copy
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