Organization
REGION TEN CSB
Active
Organization
REGION TEN CSB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHRISTINA RAGLAND (ADMINISTRATIVE ACCOUNT TECH)
(434) 972-1800
Entity
Organization
Contact information
Practice address
800 PRESTON AVE, CHARLOTTESVILLE, VA 22903-4420
(434) 972-1800
(434) 970-2104
Mailing address
800 PRESTON AVE, CHARLOTTESVILLE, VA 22903-4420
(434) 972-1800
(434) 970-2104
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
0904002900
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11478114
CAQH PROVIDER ID
VA
Enumeration date
08/04/2006
Last updated
08/22/2020
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