Healthcare Provider Details

I. General information

NPI: 1053486621
Provider Name (Legal Business Name): VIRGINIA BAPTIST CHILDRENS HOME AND FAMILY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

860 MOUNT VERNON LN
SALEM VA
24153-2700
US

IV. Provider business mailing address

860 MOUNT VERNON LN
SALEM VA
24153-2700
US

V. Phone/Fax

Practice location:
  • Phone: 540-387-5024
  • Fax: 540-444-4681
Mailing address:
  • Phone: 540-389-5468
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number229-01-001
License Number StateVA

VIII. Authorized Official

Name: ALLYSON MILLER-HAVENS
Title or Position: REVENUE CYCLE MANAGER
Credential:
Phone: 540-389-5468