Organization
LIFE SUPPORT MH COMMUNITY SUPPORT SERVICES
Active
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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