Provider Demographics
NPI:1033724216
Name:PATRICK HENRY FAMILY SERVICES OPERATIONS
Entity Type:Organization
Organization Name:PATRICK HENRY FAMILY SERVICES OPERATIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWANDOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-376-2006
Mailing Address - Street 1:1621 ENTERPRISE DR
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-5797
Mailing Address - Country:US
Mailing Address - Phone:434-376-2006
Mailing Address - Fax:434-239-4955
Practice Address - Street 1:1621 ENTERPRISE DR
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-5797
Practice Address - Country:US
Practice Address - Phone:434-376-2006
Practice Address - Fax:434-239-4955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-14
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty