Provider Demographics
NPI:1104858653
Name:HANOVER COUNTY BOARD OF SUPERVISORS
Entity Type:Organization
Organization Name:HANOVER COUNTY BOARD OF SUPERVISORS
Other - Org Name:HANOVER COUNTY COMMUNITY SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:M
Authorized Official - Last Name:SLAVEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:804-365-4275
Mailing Address - Street 1:12300 WASHINGTON HWY
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:VA
Mailing Address - Zip Code:23005-7646
Mailing Address - Country:US
Mailing Address - Phone:804-365-4222
Mailing Address - Fax:804-365-4252
Practice Address - Street 1:12300 WASHINGTON HWY
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:VA
Practice Address - Zip Code:23005-7646
Practice Address - Country:US
Practice Address - Phone:804-365-4222
Practice Address - Fax:804-365-4252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty