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General NPI Number Information
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NPI Number | 1831240647
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Entity Type | Organization
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Legal Business Name | VIRPARK INC RESIDENTIAL FACILITY
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 619 CREEK RIDGE RD
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City | GREENSBORO
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State | NC
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Zip | 27406-4303
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Country | US
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Telephone | 336-271-4002
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Fax | 336-271-3775
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Provider Business Mailing Address
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Address Line | PO BOX 321
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City | PLEASANT GARDEN
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State | NC
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Zip | 27313-8232
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER DIRECTOR
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Name | VIRGINIA PARKER
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Credential |
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Telephone | 336-271-4002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number | MHL-041-671
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number | MHL-041-671
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License Number State | NC
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