Basic Information
| Provider Information | |||||||||
| NPI: | 1477797090 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CENTRAL VIRGINIA COMMUNITY SERVICES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 620 COURT ST | ||||||||
| Address2: | |||||||||
| City: | LYNCHBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 245041312 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4344858861 | ||||||||
| FaxNumber: | 4344858877 | ||||||||
| Practice Location | |||||||||
| Address1: | 620 COURT ST | ||||||||
| Address2: | |||||||||
| City: | LYNCHBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 245041312 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4344858861 | ||||||||
| FaxNumber: | 4344858877 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/27/2009 | ||||||||
| LastUpdateDate: | 04/27/2009 | ||||||||
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| AuthorizedOfficialLastName: | COTTINGHAM | ||||||||
| AuthorizedOfficialFirstName: | NANCY | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 4348478050 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | 088-07-005 | VA | Y | Agencies | Community/Behavioral Health |
No ID Information.