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General NPI Number Information
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NPI Number | 1053753343
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Entity Type | Organization
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Legal Business Name | CENTER FOR INTEGRATED RECOVERY, LLC
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Dates
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Enumeration Date | 07/26/2013
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Last Update Date | 07/22/2016
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Provider Practice Location Address
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Address Line | 1110 ROSE HILL DR SUITE 201
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22903-5159
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Country | US
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Telephone | 434-414-7203
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Fax |
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Provider Business Mailing Address
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Address Line | 2081 DEEP CREEK RD
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City | PALMYRA
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State | VA
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Zip | 22963-4616
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Country | US
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Telephone | 434-414-7203
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ERINN ILYSE FALLS
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Credential | MSW, LCSW
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Telephone | 434-414-7203
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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 | 0904007808
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License Number State | VA
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