Organization
COMMUNITY LIVING, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERI BISTARKEY LCSW (CLINICAL DIRECTOR)
(434) 447-8381
Entity
Organization
Contact information
Practice address
314 E ATLANTIC ST, SOUTH HILL, VA 23970-2006
(434) 447-8381
(434) 447-8381
Mailing address
PO BOX 876, BRACEY, VA 23919-0876
(434) 447-8381
(434) 447-8381
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904004677
VA
251C00000X
Developmentally Disabled Services Day Training Agency
823
VA
Other
Enumeration date
07/30/2007
Last updated
07/30/2007
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