Organization
B.A.G.H., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN EVERITT BROWN (MANAGER)
(757) 869-4030
Entity
Organization
Contact information
Practice address
3605 SUMMIT LOOP, WILLIAMSBURG, VA 23188-2771
(757) 869-4030
Mailing address
3605 SUMMIT LOOP, WILLIAMSBURG, VA 23188-2771
(757) 869-4030
(757) 673-7743
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/20/2012
Last updated
11/20/2012
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