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General NPI Number Information
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NPI Number | 1043572597
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Entity Type | Organization
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Legal Business Name | VISION BEHAVIORAL HEALTH SERVICES OF VA.
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Dates
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Enumeration Date | 06/11/2012
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Last Update Date | 06/11/2012
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Provider Practice Location Address
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Address Line | 1315 2ND ST SW SUITE 102
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City | ROANOKE
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State | VA
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Zip | 24016-4944
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Country | US
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Telephone | 540-206-3677
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Fax | 540-206-2614
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Provider Business Mailing Address
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Address Line | 1315 2ND ST SW SUITE 102
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City | ROANOKE
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State | VA
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Zip | 24016-4944
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MS. SHARON ELIZABETH GARRETT
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Credential | M.ED.
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Telephone | 336-831-5480
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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