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General NPI Number Information
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NPI Number | 1144358193
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Entity Type | Individual
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Provider Name | MRS. ROBERTA LOVING GROOMS
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Gender | Female
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1223 FILLMORE ST
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City | LYNCHBURG
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State | VA
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Zip | 24501
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Country | US
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Telephone | 434-528-5245
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Fax | 434-846-0491
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Provider Business Mailing Address
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Address Line | 1007 FEDERAL ST
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City | LYNCHBURG
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State | VA
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Zip | 24504
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Country | US
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Telephone | 434-845-4403
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Fax | 434-846-0491
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | 102
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number | 102
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License Number State | VA
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