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5650 Hollins Rd Roanoke VA 24019-5056 | |
| (540) 265-8923 | |
| (540) 206-1007 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5650 Hollins Rd, Roanoke, Virginia |
| Authorized Official Name and Position | Renee Brown (CEO) |
| Authorized Official Contact | 5402658923 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5650 Hollins Rd Roanoke VA 24019-5056 Ph: (540) 265-8923 | 5650 Hollins Rd Roanoke VA 24019-5056 Ph: (540) 265-8923 |
| NPI Number | 1063432995 |
|---|---|
| Provider Enumeration Date | 07/21/2006 |
| Last Update Date | 11/21/2023 |
| Certification Date | 11/21/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063432995 | NPI | - | NPPES |
| 004946413 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 02305001 (Virginia) | Primary |
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