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General NPI Number Information
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NPI Number | 1689125767
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Entity Type | Organization
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Legal Business Name | VIRGINIA BAPTIST CHILDREN'S HOME AND FAMILY SERVICES
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Dates
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Enumeration Date | 10/24/2016
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Last Update Date | 10/24/2016
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Provider Practice Location Address
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Address Line | 107 CLEARVIEW DR
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City | MARTINSVILLE
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State | VA
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Zip | 24112-1501
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Country | US
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Telephone | 276-790-3720
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Fax | 276-790-3725
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Provider Business Mailing Address
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Address Line | PO BOX 849 860 MT VERNON LANE
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City | SALEM
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State | VA
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Zip | 24153-0849
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Country | US
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Telephone | 540-389-5468
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Fax | 540-389-5570
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Authorized Official
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Title or Position | PRESIDENT AND EXECUTIVE DIRECTOR
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Name | DR. STEPHEN RICHERSON
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Credential | PHD
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Telephone | 540-389-5468
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253J00000X
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Taxonomy Name | Foster Care Agency
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License Number | CPA13
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License Number State | VA
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