Healthcare Provider Details

I. General information

NPI: 1619082302
Provider Name (Legal Business Name): LITTLE SISTERS OF ST FRANCIS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 06/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 HUNTSMAN TRL
QUINTON VA
23141-2149
US

IV. Provider business mailing address

4801 HUNTSMAN TRL
QUINTON VA
23141-2149
US

V. Phone/Fax

Practice location:
  • Phone: 804-932-3581
  • Fax: 804-932-4349
Mailing address:
  • Phone: 804-932-3581
  • Fax: 804-932-4349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number75001001
License Number StateVA

VIII. Authorized Official

Name: MS. MARGARET WALUBUKA
Title or Position: PRESIDENT
Credential:
Phone: 757-564-7371