| Blue Ridge Alternatives, Llc | |
|
695 E Main St Wytheville VA 24382-2034 | |
| (276) 228-8300 | |
| Not Available |
| Full Name | Blue Ridge Alternatives, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 695 E Main St, Wytheville, Virginia |
| Authorized Official Name and Position | Mary Frances Henslee (OWNER/MANAGER) |
| Authorized Official Contact | 2762288300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Ridge Alternatives, Llc 385 Church St Wytheville VA 24382-2621 Ph: (276) 228-8300 | Blue Ridge Alternatives, Llc 695 E Main St Wytheville VA 24382-2034 Ph: (276) 228-8300 |
| NPI Number | 1760704852 |
|---|---|
| Provider Enumeration Date | 02/17/2010 |
| Last Update Date | 02/06/2012 |
| Medicare PECOS PAC ID | 1052446044 |
|---|---|
| Medicare Enrollment ID | O20100316000567 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760704852 | NPI | - | NPPES |
| 7471563 | Other | VA | AETNA |
| 102148 | Other | VA | ANTHEM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 0904005070 (Virginia) | Primary |
| Provider Name | Mary F Henslee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265513014 PECOS PAC ID: 1951445253 Enrollment ID: I20100224000996 |
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