Organization
COMMUNITY LIVING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL FREDRICK SHAFFREN (CO-OWNER/EXECUTIVE DIRECTOR)
(540) 943-7911
Entity
Organization
Contact information
Practice address
1304 IVY ST, WAYNESBORO, VA 22980-2625
(540) 943-7911
(540) 943-7918
Mailing address
1304 IVY ST, WAYNESBORO, VA 22980-2625
(540) 943-7911
(540) 943-7918
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
500-01-001
VA
Other
Enumeration date
10/23/2006
Last updated
08/22/2020
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