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THE OLIVIA TAYLOR HOUSE, LLC
NPI 1386233419
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Petersburg, VA

Active since January 13, 2021
628 OLD WAGNER RD, PETERSBURG, VA 23805(804) 605-6146 Get Directions Write a Review

NPPES record last updated: January 13, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About The Olivia Taylor House, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THE OLIVIA TAYLOR HOUSE, LLC (NPI 1386233419) is a healthcare organization registered as a community based residential treatment facility, intellectual and/or developmental disabilities in Petersburg, Virginia and active in the NPI registry since January 2021. The organization lists T'andrea Lenon Graham, Executive Director/owner, as its authorized official.

NPPES Registry Identity

NPI1386233419
Entity TypeOrganization
Primary Taxonomy320900000X
Legal Business NameTHE OLIVIA TAYLOR HOUSE, LLC
Location Address628 OLD WAGNER RDPetersburg, VA 23805-9319
Mailing Address628 Old Wagner RdPetersburg, VA 23805-9319 · (804) 605-6146
Phone(804) 605-6146
Organization SubpartNo
Authorized OfficialT'andrea Lenon GrahamExecutive Director/owner · (804) 605-6146
Enumeration DateJanuary 13, 2021
NPPES CertifiedJanuary 13, 2021
✔ NPI 1386233419 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities
Taxonomy Code320900000X
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.
628 OLD WAGNER RD, Petersburg, VA 23805
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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TANDREA GRAHAM MSW
Community Health Worker
628 OLD WAGNER RD
PETERSBURG, VA 23805
Petersburg City (804) 605-6146

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is The Olivia Taylor House, LLC's NPI number?

The NPI number for The Olivia Taylor House, LLC is 1386233419. It was assigned to this organization in the NPPES registry on January 13, 2021.

Where is The Olivia Taylor House, LLC located?

The Olivia Taylor House, LLC is located at 628 Old Wagner Rd, Petersburg, VA 23805. The listed phone number is (804) 605-6146.

What is The Olivia Taylor House, LLC's specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320900000X.

When was this NPI record last updated?

The NPPES record for The Olivia Taylor House, LLC was last updated on January 13, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.