Organization
BLUE RIDGE GROUP HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA MCPHEARSON (OWNER)
(540) 219-5110
Entity
Organization
Contact information
Practice address
11018 OLD STILLHOUSE RD, BOSTON, VA 22713-4031
(540) 219-5110
Mailing address
11018 OLD STILLHOUSE RD, BOSTON, VA 22713-4031
(540) 219-5110
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
—
—
Other
Enumeration date
07/31/2017
Last updated
07/21/2022
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