Organization
GOODWILL INDUSTRIES OF THE VALLEYS - ROCKY MOUNT
Active
Other names
Goodwill Industries of the Valleys Southern Division
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRUCE PHIPPS (PRESIDENT AND CEO)
(540) 581-0620
Entity
Organization
Contact information
Practice address
1045 NORTH MAIN STREET, ROCKY MOUNT, VA 24151
(540) 483-9559
(540) 483-0297
Mailing address
2502 MELROSE AVENUE NW, SUITE A, ROANOKE, VA 24017
(540) 581-0620
(540) 581-0628
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
240
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004947339
—
VA
Enumeration date
09/20/2006
Last updated
05/29/2015
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