Healthcare Provider Details

I. General information

NPI: 1215276639
Provider Name (Legal Business Name): PARTLOW QUALITY ADULT CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2013
Last Update Date: 02/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5220 DICKERSON RD
PARTLOW VA
22534-9789
US

IV. Provider business mailing address

5220 DICKERSON RD
PARTLOW VA
22534-9789
US

V. Phone/Fax

Practice location:
  • Phone: 540-894-6464
  • Fax:
Mailing address:
  • Phone: 540-894-6464
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. ELNORA ELIZABETH POPE
Title or Position: CEO/PROVIDER
Credential:
Phone: 540-894-6464