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Organization

RAGGED MOUNTAIN HOME, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. EUGENE JOSEPH CONTI (OWNER)
(434) 293-7641
Entity
Organization

Contact information

Practice address
1176 RESERVOIR RD, CHARLOTTESVILLE, VA 22903-7761
(434) 293-7641
(434) 293-8404
Mailing address
1176 RESERVOIR RD, CHARLOTTESVILLE, VA 22903-7761
(434) 293-7641
(434) 293-8404

Taxonomy

Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
472-14-001
VA
323P00000X
Psychiatric Residential Treatment Facility
Primary
472-14-001
VA

Other

Enumeration date
03/31/2010
Last updated
03/31/2010
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