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NPI Code Detail

MEDICARE: GLOECKNER WEBER, LLC

MEDICARE: GLOECKNER WEBER, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1320600000XIntellectual and/or Developmental Disabilities Residential Treatment FacilitySS-203-05VA

General Provider Information

NPI Number : 1417131954
Entity Type Code : Organization
Provider Name (Legal Business Name) : GLOECKNER WEBER, LLC
Provider Business Mailing Address
First Line : 536 PANTOPS CTR
Second Line : PMB 338
City : CHARLOTTESVILLE
State : VA
Zip : 22911-8665
Country : US
Telephone Number : 434-970-1904
Fax Number :
Provider Business Practice Location Address
First Line : 517 PARK ST
Second Line :
City : CHARLOTTESVILLE
State : VA
Zip : 22902-4739
Country : US
Telephone Number : 434-970-1904
Fax Number :
Authorized Official
Title or Position : CFO
Name : MR. JAMES ROBERT CATO
Credential :
Telephone Number : 434-970-1904
Provider Enumeration Date : 12/19/2007
Last Update Date : 12/19/2007

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Directions to “GLOECKNER WEBER, LLC ” Practice Location

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