Provider Demographics
NPI:1225316110
Name:CHILDREN'S ADVOCACY PROGRAMS OF THE BLUE RIDGE, INC.
Entity Type:Organization
Organization Name:CHILDREN'S ADVOCACY PROGRAMS OF THE BLUE RIDGE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:CROUCH
Authorized Official - Last Name:MORAN
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:540-484-5566
Mailing Address - Street 1:300 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:VA
Mailing Address - Zip Code:24151-1711
Mailing Address - Country:US
Mailing Address - Phone:540-484-5566
Mailing Address - Fax:
Practice Address - Street 1:300 S MAIN ST
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:VA
Practice Address - Zip Code:24151-1711
Practice Address - Country:US
Practice Address - Phone:540-484-5566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-27
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center