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General NPI Number Information
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NPI Number | 1962872663
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Entity Type | Organization
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Legal Business Name | VIRGINIA TECH ADULT DAY SERVICES
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Dates
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Enumeration Date | 10/07/2015
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Last Update Date | 10/07/2015
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Provider Practice Location Address
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Address Line | 102 WALLACE HALL (0416)
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City | BLACKBURG
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State | VA
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Zip | 24061
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Country | US
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Telephone | 540-231-3161
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Fax | 540-231-8786
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Provider Business Mailing Address
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Address Line | 102 WALLACE HALL (0416)
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City | BLACKBURG
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State | VA
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Zip | 24061
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Country | US
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Telephone | 540-231-3161
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Fax | 540-231-8786
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Authorized Official
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Title or Position | DIRECTOR
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Name | ILA W SCHEPISI
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Credential |
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Telephone | 540-231-3161
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | ADC786701
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License Number State | VA
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