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General NPI Number Information
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NPI Number | 1477705176
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Entity Type | Organization
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Legal Business Name | REAVES-DIGGS, PARHAM & ASSOCIATES, LLC
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Dates
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Enumeration Date | 10/14/2008
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Last Update Date | 10/14/2008
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Provider Practice Location Address
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Address Line | 147 MILL RIDGE RD STE 203
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City | LYNCHBURG
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State | VA
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Zip | 24502-4341
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Country | US
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Telephone | 434-237-5005
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Fax | 434-237-5535
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Provider Business Mailing Address
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Address Line | PO BOX 2513 LYNCHBURG
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City | VIRGINIA BCH
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State | VA
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Zip | 23450-2513
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Country | US
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Telephone | 434-237-5005
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Fax | 434-237-5535
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. ELIZABETH TRACCINNIEA REAVES
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Credential |
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Telephone | 434-237-5005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | SS-381/4271-08
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License Number State | VA
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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 | SS-04-47
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License Number State | VA
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