Provider Demographics
NPI:1215102785
Name:POWR, INC.
Entity type:Organization
Organization Name:POWR, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DERMAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:SPRAGG
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:804-515-8017
Mailing Address - Street 1:PO BOX 15454
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23227-5454
Mailing Address - Country:US
Mailing Address - Phone:804-515-8017
Mailing Address - Fax:804-515-7513
Practice Address - Street 1:6300 WHISTLER RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23227-1606
Practice Address - Country:US
Practice Address - Phone:804-515-8017
Practice Address - Fax:804-515-7513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-25
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA88-259-46320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness