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General NPI Number Information
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NPI Number | 1518991561
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Entity Type | Organization
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Legal Business Name | WORKSOURCE ENTERPRISES, INC.
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1311 CARLTON AVE
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22902-5837
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Country | US
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Telephone | 434-972-1730
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Fax | 434-972-7412
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Provider Business Mailing Address
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Address Line | 1311 CARLTON AVE
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22902-5837
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Country | US
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Telephone | 434-972-1730
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Fax | 434-972-7412
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHARLES J. MCELROY
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Credential |
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Telephone | 434-972-1730
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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 | 104-02-006
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License Number State | VA
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