Organization
FAMILY SENIOR PARTNERSHIP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY W STADNICK EMT (MANAGER)
(804) 798-4419
Entity
Organization
Contact information
Practice address
12270 MOUNT HERMON RD, ASHLAND, VA 23005-7807
(804) 798-4419
(804) 798-2265
Mailing address
12270 MOUNT HERMON RD, ASHLAND, VA 23005-7807
(804) 798-4419
(804) 798-2265
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
B030908501
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0100792255
—
VA
Enumeration date
12/01/2016
Last updated
12/01/2016
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