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General NPI Number Information
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NPI Number | 1013241462
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Entity Type | Organization
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Legal Business Name | CENTRAL VIRGINIA HEALTH DISTRICT EARLY INTERVENTION
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Dates
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Enumeration Date | 10/01/2009
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Last Update Date | 10/01/2009
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Provider Practice Location Address
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Address Line | 1900 THOMSON DR
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City | LYNCHBURG
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State | VA
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Zip | 24501-1009
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Country | US
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Telephone | 434-947-2888
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Fax | 434-947-2389
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Provider Business Mailing Address
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Address Line | 1900 THOMSON DR
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City | LYNCHBURG
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State | VA
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Zip | 24501-1009
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Country | US
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Telephone | 434-947-2888
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Fax | 434-947-2389
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Authorized Official
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Title or Position | SYSTEM MANAGER
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Name | GAIL BRICELAND
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Credential | RN, CPNP, MSN
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Telephone | 434-947-2888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | 0024079452
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License Number State | VA
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