Healthcare Provider Details

I. General information

NPI: 1730239922
Provider Name (Legal Business Name): GRAFTON SCHOOL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 10/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 CHILDRENS CENTER RD SW
LEESBURG VA
20175-2545
US

IV. Provider business mailing address

PO BOX 2500 FINANCE
WINCHESTER VA
22604-1700
US

V. Phone/Fax

Practice location:
  • Phone: 703-777-3485
  • Fax: 703-777-4887
Mailing address:
  • Phone: 540-542-0200
  • Fax: 540-542-0200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number030-14-001
License Number StateVA

VIII. Authorized Official

Name: MRS. VANESSA LANE
Title or Position: DIRECTOR, ACCOUNTS RECEIVABLE
Credential:
Phone: 540-542-0200