| Commonwealth Center For Children And Adolescents | |
|
1355 Richmond Ave Staunton VA 24401-9146 | |
| (540) 332-2142 | |
| (540) 332-2209 |
| Full Name | Commonwealth Center For Children And Adolescents |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 1355 Richmond Ave, Staunton, Virginia |
| Authorized Official Name and Position | Terry Dwight Crickenberger (NURSE PRACTITIONER) |
| Authorized Official Contact | 5403322142 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Commonwealth Center For Children And Adolescents Po Box 4000 Staunton VA 24402-4000 Ph: (540) 332-2142 | Commonwealth Center For Children And Adolescents 1355 Richmond Ave Staunton VA 24401-9146 Ph: (540) 332-2142 |
| NPI Number | 1700154713 |
|---|---|
| Provider Enumeration Date | 12/05/2011 |
| Last Update Date | 12/05/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700154713 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 0017139232 (Virginia) | Primary |
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