Organization
THE BRANCH COMMUNITY GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMI WEST BAGWELL QMHP,QDDP (PROGRAM DIRECTOR)
(757) 709-9001
Entity
Organization
Contact information
Practice address
24293 LANKFORD HIGHWAY, TASLEY, VA 23441
(757) 709-9001
(757) 787-1122
Mailing address
PO BOX 306, ACCOMAC, VA 23301-0306
(757) 709-9001
(757) 787-3456
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
10/28/2019
Last updated
03/31/2021
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