Healthcare Provider Details

I. General information

NPI: 1447621867
Provider Name (Legal Business Name): GENERATIONS CROSSING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2015
Last Update Date: 10/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3765 TAYLOR SPRING LANE
HARRISONBURG VA
22801
US

IV. Provider business mailing address

3765 TAYLOR SPRING LANE
HARRISONBURG VA
22801
US

V. Phone/Fax

Practice location:
  • Phone: 540-443-4901
  • Fax:
Mailing address:
  • Phone: 540-443-4901
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number1103663-L709
License Number StateVA

VIII. Authorized Official

Name: LAURIE DEAVERS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 540-434-4901