Healthcare Provider Details

I. General information

NPI: 1801904529
Provider Name (Legal Business Name): COMMONWEALTH OF VA. DEPT.OF BEHAVIORAL HLTH&CENTRAL VA. TRAINING CENTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 06/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 COLONY RD
MADISON HEIGHTS VA
24572-2105
US

IV. Provider business mailing address

521 COLONY RD
MADISON HEIGHTS VA
24572-2105
US

V. Phone/Fax

Practice location:
  • Phone: 434-947-6000
  • Fax: 434-947-2140
Mailing address:
  • Phone: 434-947-6000
  • Fax: 434-947-2140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateVA

VIII. Authorized Official

Name: DR. ALLEN D. WOODS
Title or Position: FACILITY DIRECTOR
Credential: PH.D
Phone: 434-947-6000