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General NPI Number Information
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NPI Number | 1316695497
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Entity Type | Organization
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Legal Business Name | EMS VA LLC
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Dates
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Enumeration Date | 03/16/2022
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Last Update Date | 10/10/2024
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Provider Practice Location Address
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Address Line | 3540 E BROAD ST STE 120-402
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City | MANSFIELD
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State | TX
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Zip | 76063-5633
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Country | US
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Telephone | 804-332-5696
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Fax |
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Provider Business Mailing Address
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Address Line | 707 N COURTHOUSE RD
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23236-4045
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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 | DIRECTOR
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Name | SUZANNE M CHRISTOPHER
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Credential |
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Telephone | 540-809-1882
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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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 | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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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 | 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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