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General NPI Number Information
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NPI Number | 1073963666
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Entity Type | Organization
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Legal Business Name | PULASKI ADULT DAY SERVICE & FALL PREVENTION CENTER, INC.
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Dates
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Enumeration Date | 06/15/2016
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Last Update Date | 06/15/2016
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Provider Practice Location Address
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Address Line | 211 FIFTH STREET
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City | DUBLIN
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State | VA
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Zip | 24084-0877
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Country | US
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Telephone | 540-320-1534
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Fax |
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Provider Business Mailing Address
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Address Line | 211 FIFTH STREET
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City | DUBLIN
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State | VA
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Zip | 24084-0877
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Country | US
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Telephone | 540-320-1534
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DR. LINDA SUE DAVIS
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Credential |
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Telephone | 540-320-1534
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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