Healthcare Provider Details

I. General information

NPI: 1154347342
Provider Name (Legal Business Name): GOOCHLAND COUNTY PUBLIC SCHOOLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2938 WEST RIVER ROAD
GOOCHLAND VA
23063
US

IV. Provider business mailing address

225 LAMBS LN
CHARLOTTESVILLE VA
22901-8951
US

V. Phone/Fax

Practice location:
  • Phone: 804-556-5625
  • Fax: 804-556-3847
Mailing address:
  • Phone: 434-975-9400
  • Fax: 434-975-9401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: DR. MARY MCMANUS
Title or Position: EXECUTIVE DIRECTOR
Credential: PHD
Phone: 434-975-9400