Healthcare Provider Details

I. General information

NPI: 1891013009
Provider Name (Legal Business Name): LUTHERAN FAMILY SERVICES OF VIRGINIA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2010
Last Update Date: 05/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 W CLUB LN
RICHMOND VA
23226-2428
US

IV. Provider business mailing address

2609 MCVITTY RD
ROANOKE VA
24018-3513
US

V. Phone/Fax

Practice location:
  • Phone: 804-288-0122
  • Fax: 804-288-0123
Mailing address:
  • Phone: 540-774-7100
  • Fax: 540-774-1084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. JULIE SWANSON
Title or Position: CEO
Credential:
Phone: 540-774-7100