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Organization

JUNCTION CENTER FOR INDEPENDENT LIVING, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SHARON STACEY (PROGRAM DIRECTOR)
(276) 524-4081
Entity
Organization

Contact information

Practice address
1520 3RD AVE E, BIG STONE GAP, VA 24219-3114
(276) 524-4081
(276) 524-1510
Mailing address
1520 3RD AVE E, BIG STONE GAP, VA 24219-3114
(276) 524-4081
(276) 524-1510

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
008744041
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
008743908
VA
05
008744041
VA
05
1376761304
VA
Enumeration date
04/23/2007
Last updated
01/24/2024
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