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General NPI Number Information
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NPI Number | 1477887198
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Entity Type | Organization
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Legal Business Name | KING'S HEART REIDENTIAL AND FAMILY SERVICES
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Dates
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Enumeration Date | 09/28/2009
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Last Update Date | 09/28/2009
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Provider Practice Location Address
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Address Line | 1720 NORWOOD RD
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City | BRUINGTON
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State | VA
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Zip | 23023-4158
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Country | US
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Telephone | 804-445-1312
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Fax | 804-443-5380
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Provider Business Mailing Address
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Address Line | 1720 NORWOOD RD
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City | BRUINGTON
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State | VA
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Zip | 23023-4158
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Country | US
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Telephone | 804-445-1312
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Fax | 804-443-5380
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Authorized Official
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Title or Position | CEO
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Name | MR. MICHAEL BROOKS ARRINGTON
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Credential | M.P.A.
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Telephone | 804-445-1312
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | 1524-01-001
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | 1524-01-001
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License Number State | VA
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