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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