| Opening Gates, Llc | |
|
670 Highway Ninety Two Boydton VA 23917-2234 | |
| (434) 738-6566 | |
| (434) 738-6566 |
| Full Name | Opening Gates, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 670 Highway Ninety Two, Boydton, Virginia |
| Authorized Official Name and Position | Mary Alice Walters (SOCIAL WORKER) |
| Authorized Official Contact | 4347386566 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Opening Gates, Llc 670 Highway Ninety Two Boydton VA 23917-2234 Ph: (434) 738-6566 | Opening Gates, Llc 670 Highway Ninety Two Boydton VA 23917-2234 Ph: (434) 738-6566 |
| NPI Number | 1427372655 |
|---|---|
| Provider Enumeration Date | 03/17/2010 |
| Last Update Date | 03/17/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427372655 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 0904002624 (Virginia) | Primary |
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