Provider Demographics
NPI:1033631585
Name:ANDERSON & ASSOCIATES, LLC
Entity Type:Organization
Organization Name:ANDERSON & ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLEY
Authorized Official - Middle Name:REBECCA
Authorized Official - Last Name:BURNETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-400-7841
Mailing Address - Street 1:4212 CYPRESS PARK DR
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-8417
Mailing Address - Country:US
Mailing Address - Phone:540-400-7841
Mailing Address - Fax:540-400-8177
Practice Address - Street 1:4212 CYPRESS PARK DR
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-8417
Practice Address - Country:US
Practice Address - Phone:540-400-7841
Practice Address - Fax:540-400-8177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility