Organization
MOUNT ROGERS COMMUNITY SERVICES
Active
Other names
Green Valley Intermediate Care Facility
Organization subpart
No
Provider details
NPI number
Authorized official
LISA B MARTIN (REIMBURSEMENT MANAGER)
(276) 223-3200
Entity
Organization
Contact information
Practice address
795 FAIRVIEW RD, WYTHEVILLE, VA 24382-4501
(276) 223-3200
(276) 223-0617
Mailing address
770 W RIDGE RD, WYTHEVILLE, VA 24382-1187
(276) 223-3200
(276) 223-0617
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Enumeration date
01/20/2020
Last updated
01/20/2020
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