Organization
COMMONWEALTH OF VIRGINIA STATE DEPARTMENT OF HEALTH
Active
Parent organization
COMMONWEALTH OF VIRGINIA STATE DEPARTMENT OF HEALTH
Other names
Central Virginia Child Development Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMMONWEALTH OF VIRGINIA STATE DEPARTMENT OF HEALTH
Authorized official
MRS. GAIL J BRICELAND RN PNP (DIRECTOR)
(434) 947-2030
Entity
Organization
Contact information
Practice address
1900 THOMSON DR, CHILD DEVELOPMENT CLINIC, LYNCHBURG, VA 24501-1009
(434) 947-2030
(434) 947-2389
Mailing address
PO BOX 11768, CHILD DEVELOPMENT CLINIC, LYNCHBURG, VA 24506-1768
(434) 947-2030
(434) 947-2389
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003374
ANTHEM
VA
01
—
004975111
VIRGINIA PREMIER
VA
05
—
004975111
—
VA
01
—
18765
OPTIMA
VA
01
—
61176
CARENET
VA
Enumeration date
10/23/2006
Last updated
06/27/2008
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