Organization
RAPPAHANNOCK AREA COMMUNITY SERVICES BOARD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD WADE BRANSCOME (EXECUTIVE DIRECTOR)
(540) 899-4370
Entity
Organization
Contact information
Practice address
5604 ROSS DR, FREDERICKSBURG, VA 22407-5702
(540) 785-4909
(540) 785-4910
Mailing address
600 JACKSON ST, FREDERICKSBURG, VA 22401-5719
(540) 373-3223
(540) 371-3753
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
101-01-005
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C01242
MEDICARE PTAN NUMBER
VA
Enumeration date
08/20/2014
Last updated
09/11/2014
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