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General NPI Number Information
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NPI Number | 1619388220
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Entity Type | Organization
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Legal Business Name | MCAP CHRISTIANSBURG LLC
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Dates
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Enumeration Date | 05/16/2014
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Last Update Date | 05/16/2014
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Provider Practice Location Address
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Address Line | 201 WHEATLAND CT
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City | CHRISTIANSBURG
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State | VA
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Zip | 24073-1091
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Country | US
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Telephone | 540-382-5200
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Fax | 540-382-7154
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Provider Business Mailing Address
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Address Line | 534 E MAIN ST STE B
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22902-5395
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Country | US
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Telephone | 434-220-1055
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Fax | 434-295-4851
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Authorized Official
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Title or Position | COMPLIANCE MANAGER
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Name | MS. CHERYL C BRUNK
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Credential |
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Telephone | 434-220-1055
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | ALF 1104120
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License Number State | VA
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