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General NPI Number Information
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NPI Number | 1407934672
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Entity Type | Organization
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Legal Business Name | RUBICON, INC
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 07/15/2008
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Provider Practice Location Address
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Address Line | 2825 RADY ST
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City | RICHMOND
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State | VA
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Zip | 23222-4097
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Country | US
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Telephone | 804-767-6600
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Fax | 804-321-2997
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Provider Business Mailing Address
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Address Line | 1300 MACTAVISH AVE
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City | RICHMOND
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State | VA
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Zip | 23230-4616
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Country | US
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Telephone | 804-359-3255
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Fax | 804-359-5137
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Authorized Official
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Title or Position | DEPUTY DIRECTOR
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Name | MRS. BARBARA J THORNHILL
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Credential |
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Telephone | 804-381-6307
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 16101033
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License Number State | VA
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