District 19 Community Services Board
Early Intervention Provider Agency in Petersburg, VA. Organization (NPI-2).
NPI number1669970646
StatusActive
Last updated in NPPESJan 25, 2018
Details
- NPI
- 1669970646
- Entity type
- Organization (NPI-2)
- Legal business name
- District 19 Community Services Board
- Organization subpart
- No
- Enumeration date
- Jan 25, 2018
- Last updated
- Jan 25, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 252Y00000X | Early Intervention Provider Agency | 184 | VA | Yes |
Practice location
20 W Bank St Ste 5Petersburg, VA 23803-3279
Phone 804-862-6082 · Fax 804-862-6158
Mailing address
20 W Bank St Ste 7Petersburg, VA 23803-3279
Phone 804-862-6082 · Fax 804-862-6158
Authorized official
Lisa A Newby
Executive Assistant
8048626082
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