MEDICARE: VICTORIA BARROW

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
1	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility	4543	VA

General Provider Information

NPI Number	:	1558101709
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA BARROW

Provider Business Mailing Address
First Line	:	6420 DAWNFIELD LN
Second Line	:
City	:	HENRICO
State	:	VA
Zip	:	23231-5334
Country	:	US
Telephone Number	:	804-274-0223
Fax Number	:

Provider Business Practice Location Address
First Line	:	1303 OAKLAND RD
Second Line	:
City	:	HENRICO
State	:	VA
Zip	:	23231-4759
Country	:	US
Telephone Number	:	804-274-0223
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2024
Last Update Date	:	05/27/2024

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Directions to “ VICTORIA BARROW ” Practice Location

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