Basic Information
| Provider Information | |||||||||
| NPI: | 1881886133 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HARRISONBURG ROCKINGHAM COMMUNITY SERVICES BOARD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1241 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | HARRISONBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 228024632 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5404341941 | ||||||||
| FaxNumber: | 5404338277 | ||||||||
| Practice Location | |||||||||
| Address1: | 463 E WASHINGTON ST | ||||||||
| Address2: | |||||||||
| City: | HARRISONBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 228024853 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5404333100 | ||||||||
| FaxNumber: | 5404338277 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2007 | ||||||||
| LastUpdateDate: | 02/25/2016 | ||||||||
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| AuthorizedOfficialLastName: | HARRISON | ||||||||
| AuthorizedOfficialFirstName: | ELLEN | ||||||||
| AuthorizedOfficialMiddleName: | D. | ||||||||
| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 5404341941 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 252Y00000X | VA | Y | Agencies | Early Intervention Provider Agency |
ID Information
| ID | Type | State | Issuer | Description | 004978552 | 05 | VA | MEDICAID |