Organization
MONA'S ARK
Active
Other names
Creative Therapy Care
Organization subpart
No
Provider details
NPI number
Authorized official
MONA SAMS (EXECUTIVE DIRECTOR)
(540) 204-4480
Entity
Organization
Contact information
Practice address
8249 WILLIAMSON RD, ROANOKE, VA 24019-6951
(540) 204-4480
Mailing address
8249 WILLIAMSON RD, ROANOKE, VA 24019-6951
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1427688670
—
VA
Enumeration date
02/06/2020
Last updated
02/06/2020
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