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Organization
MIDDLE PENINSULA NORTHERN NECK COMMUNITY SERVICES BOARD
Active
Organization
MIDDLE PENINSULA NORTHERN NECK COMMUNITY SERVICES BOARD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH MIDDLETON TAYLOR Q.M.R.P. (CARE COORDINATOR/CASE MANAGER)
(804) 758-5250
Entity
Organization
Contact information
Practice address
5372B OLD VIRGINIA STREET, URBANNA, VA 23175
(804) 758-5250
(804) 758-5183
Mailing address
PO BOX 40, SALUDA, VA 23149-0040
(804) 758-5250
(804) 758-5183
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
171M00000X
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
49-7813-7
—
VA
Enumeration date
09/13/2010
Last updated
09/13/2010
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