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General NPI Number Information
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NPI Number | 1962069054
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Entity Type | Organization
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Legal Business Name | SUNNY HAVEN RESIDENTAL SERVICES
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Dates
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Enumeration Date | 05/23/2019
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Last Update Date | 05/23/2019
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Provider Practice Location Address
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Address Line | 114 COLLINSWOOD DR
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City | STAUNTON
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State | VA
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Zip | 24401-1988
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Country | US
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Telephone | 540-263-0701
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Fax |
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Provider Business Mailing Address
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Address Line | 686 SPOTTSWOOD RD
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City | STEELES TAVERN
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State | VA
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Zip | 24476-2000
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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 | DIRECTOR
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Name | MISS MARCIE J ADKINS
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Credential | QUID
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Telephone | 540-480-1555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number |
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License Number State |
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Taxonomy #2
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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 |
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License Number State |
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