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General NPI Number Information
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NPI Number | 1649428962
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Entity Type | Organization
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Legal Business Name | JEFFERSON AREA CHIP, INC.
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Dates
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Enumeration Date | 08/28/2008
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Last Update Date | 01/09/2009
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Provider Practice Location Address
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Address Line | 1469 GREENBRIER PL
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22901-1697
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Country | US
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Telephone | 434-964-4702
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Fax | 434-964-4774
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Provider Business Mailing Address
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Address Line | 1469 GREENBRIER PL
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22901-1697
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Country | US
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Telephone | 434-964-4702
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Fax | 434-964-4774
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JUDY W SMITH
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Credential | RN
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Telephone | 434-964-4701
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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