Organization
LIFE SUPPORT MH COMMUNITY SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KIMBERLY HARPER GIBSON RN (OWNER)
(434) 728-2641
Entity
Organization
Contact information
Practice address
490 PINEY FOREST RD, DANVILLE, VA 24540-4060
(434) 728-2641
Mailing address
349 PINEY FOREST RD, SUITE A, DANVILLE, VA 24540-4121
(434) 728-2641
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
VA
Other
Enumeration date
10/11/2011
Last updated
12/06/2024
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