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NPI Code Detail

MEDICARE: POINDEXTERS RES CHILD CARE FACILITY

MEDICARE: POINDEXTERS RES CHILD CARE FACILITY
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 Facility18914001VA

General Provider Information

NPI Number : 1477561827
Entity Type Code : Organization
Provider Name (Legal Business Name) : POINDEXTERS RES CHILD CARE FACILITY
Provider Business Mailing Address
First Line : 1102 POINDEXTER LANE
Second Line :
City : BEDFORD
State : VA
Zip : 24523
Country : US
Telephone Number : 540-586-0518
Fax Number : 540-586-5448
Provider Business Practice Location Address
First Line : 1102 POINDEXTER LANE
Second Line :
City : BEDFORD
State : VA
Zip : 24523
Country : US
Telephone Number : 540-586-0518
Fax Number : 540-586-5448
Authorized Official
Title or Position : OWNER OPERATOR
Name : GLADYS C POINDEXTER
Credential :
Telephone Number : 540-586-0518
Provider Enumeration Date : 08/03/2006
Last Update Date : 08/22/2020

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Directions to “POINDEXTERS RES CHILD CARE FACILITY ” Practice Location

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