Organization
BLUE RIDGE ELDERCARE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY L LANDIS L.C.S.W., D.C.S.W. (PRESIDENT)
(540) 434-6354
Entity
Organization
Contact information
Practice address
59 E WEAVER AVE, HARRISONBURG, VA 22801-3047
(540) 434-6354
Mailing address
59 E WEAVER AVE, HARRISONBURG, VA 22801-3047
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904001685
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DD4151
RAILROAD GROUP NUMBER
VA
Enumeration date
10/31/2006
Last updated
11/13/2007
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