| Lutheran Family Service Of Va | |
|
515 Hurricane Rd Ne Bldg N Wise VA 24293-6745 | |
| (540) 206-3270 | |
| (540) 265-4287 |
| Full Name | Lutheran Family Service Of Va |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 515 Hurricane Rd Ne Bldg N, Wise, Virginia |
| Authorized Official Name and Position | El-freida Mae King (CONTROLLER) |
| Authorized Official Contact | 5405628473 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lutheran Family Service Of Va 2609 Mcvitty Rd Roanoke VA 24018-3513 Ph: (540) 562-8473 | Lutheran Family Service Of Va 515 Hurricane Rd Ne Bldg N Wise VA 24293-6745 Ph: (540) 206-3270 |
| NPI Number | 1902310444 |
|---|---|
| Provider Enumeration Date | 11/20/2017 |
| Last Update Date | 06/16/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902310444 | NPI | - | NPPES |
| 272 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 272 (Virginia) | Primary |
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