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COMMONWEALTH OF VIRGINIA DEPARTMENT OF BEHAVI

Intermediate Care Facility, Mental Illness

Williamsburg, Virginia

Provider NPI: 1114027521

Organization Information:
Organization Name:  COMMONWEALTH OF VIRGINIA DEPARTMENT OF BEHAVI


Practice Location:
4601 IRONBOUND RD  WILLIAMSBURG, VA 23188 US
Tel: 757-253-5241  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y310500000XNursing & Custodial Care Facilities
Intermediate Care Facility, Mental Illness

Other Provider Identifiers:

IssuerNumberStateType
004966244VA05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




INTERMEDIATE CARE JOBS VA - Page 1