L R Minor Llc | |
910 Princess Anne St Suite 109 Fredericksburg VA 22401-5844 | |
(540) 656-2106 | |
(540) 656-2107 |
Full Name | L R Minor Llc |
---|---|
Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
Location | 910 Princess Anne St, Fredericksburg, Virginia |
Authorized Official Name and Position | Linda R Minor (PRESIDENT) |
Authorized Official Contact | 5403614330 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
L R Minor Llc 910 Princess Anne St Suite 109 Fredericksburg VA 22401-5844 Ph: (540) 656-2106 | L R Minor Llc 910 Princess Anne St Suite 109 Fredericksburg VA 22401-5844 Ph: (540) 656-2106 |
NPI Number | 1508010232 |
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Provider Enumeration Date | 11/07/2008 |
Last Update Date | 11/02/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1508010232 | NPI | - | NPPES |
291952 | Other | VA | BLUE CROSS BLUE SHIELD |
80000284 | Other | VA | MEDICARE ID-TYPE UNSPECIFIED |
089122 | Other | VA | SENTARA-VETRI |
512334 | Other | VA | NCPPO |
461682000 | Other | VA | MIS |
89-1497-4 | Medicaid | VA | |
152672 | Other | VA | MHN |
4763-0001 | Other | VA | CARE FIRST BCBS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 0904002023 (Virginia) | Primary |
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