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Organization

GOOD NEIGHBOR HOMES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARY PATRICIA RODENBERG-ROBERTS (VP & SR. ASST GENERAL COUNSEL)
(952) 836-2234
Entity
Organization

Contact information

Practice address
1407 SUMMIT AVE, RICHMOND, VA 23230-4723
(804) 520-8005
Mailing address
313 CONGRESS ST, BOSTON, MA 02210-1218
(800) 388-5150
(617) 790-4271

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
251S00000X
Community/Behavioral Health Agency
748
VA
251S00000X
Community/Behavioral Health Agency

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0101497979
VA
01
4497
DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES
VA
01
748
DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES
VA
Enumeration date
06/03/2010
Last updated
09/14/2023
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