MEDICARE: VILLAGE CARE COLLABORATIVE

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	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1770277865
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VILLAGE CARE COLLABORATIVE

Provider Business Mailing Address
First Line	:	3026 FOREST ACRE CT
Second Line	:
City	:	SALEM
State	:	VA
Zip	:	24153-8761
Country	:	US
Telephone Number	:	540-819-0537
Fax Number	:

Provider Business Practice Location Address
First Line	:	3026 FOREST ACRE CT
Second Line	:
City	:	SALEM
State	:	VA
Zip	:	24153-8761
Country	:	US
Telephone Number	:	540-819-0519
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	MRS. ASHLYN FIX
Credential	:
Telephone Number	:	540-521-5122

Provider Enumeration Date	:	06/02/2023
Last Update Date	:	06/02/2023

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Directions to “VILLAGE CARE COLLABORATIVE ” Practice Location

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