Mount Rogers Community Services
Intermediate Care Facility, Intellectual Disabilities in Wytheville, VA. Organization (NPI-2).
NPI number1871123729
StatusActive
Last updated in NPPESJan 20, 2020
Details
- NPI
- 1871123729
- Entity type
- Organization (NPI-2)
- Legal business name
- Mount Rogers Community Services
- Organization subpart
- No
- Enumeration date
- Jan 20, 2020
- Certification date
- Jan 20, 2020
- Last updated
- Jan 20, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 315P00000X | Intermediate Care Facility, Intellectual Disabilities | – | – | Yes |
Other names
- Green Valley Intermediate Care Facility (Doing Business As)
Practice location
795 Fairview RdWytheville, VA 24382-4501
Phone 276-223-3200 · Fax 276-223-0617
Mailing address
770 W Ridge RdWytheville, VA 24382-1187
Phone 276-223-3200 · Fax 276-223-0617
Authorized official
Lisa B Martin
Reimbursement Manager
2762233200
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