Healthcare Provider Details

I. General information

NPI: 1093836397
Provider Name (Legal Business Name): SHELTERING ARMS HOSPITAL SOUTH, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 06/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8254 ATLEE RD
MECHANICSVILLE VA
23116-1844
US

IV. Provider business mailing address

13700 SAINT FRANCIS BLVD STE 300
MIDLOTHIAN VA
23114
US

V. Phone/Fax

Practice location:
  • Phone: 804-342-4358
  • Fax: 804-342-4316
Mailing address:
  • Phone: 804-764-1000
  • Fax: 804-342-4316

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL BOEMMEL
Title or Position: CFO
Credential:
Phone: 804-342-4340