Organization
JACKSON RIVER ENTERPRISES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHARON ANN WALTHALL (EXECUTIVE DIRECTOR)
(540) 962-3441
Entity
Organization
Contact information
Practice address
825 W EDGEMONT DR, COVINGTON, VA 24426-2759
(540) 962-3441
(540) 965-8530
Mailing address
825 W EDGEMONT DR, COVINGTON, VA 24426-2759
(540) 962-3441
(540) 965-8530
Taxonomy
Speciality
Code
Description
License number
State
170300000X
Genetic Counselor (M.S.)
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
010173515
VA
Other
Enumeration date
08/01/2006
Last updated
08/12/2008
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