Organization
BRAIN INJURY RESOURCE & DEVELOPMENT CENTER, INC.
Active
Other names
Phoenix Star Clubhouse
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JUANITA THORNTON MSW (PRESIDENT)
(540) 761-5424
Entity
Organization
Contact information
Practice address
923 14TH ST SE, ROANOKE, VA 24013-2001
(540) 761-5424
Mailing address
PO BOX 572, SHAWSVILLE, VA 24162-0572
(540) 761-5424
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
10/05/2009
Last updated
10/05/2009
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