Provider Demographics
NPI:1235468430
Name:GRAFTON SCHOOL, INC.
Entity Type:Organization
Organization Name:GRAFTON SCHOOL, INC.
Other - Org Name:GRAFTON INTEGRATED HEALTH NETWORK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR, CYCLE MNGT./ACCOUNTS RECE
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:R
Authorized Official - Last Name:LANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-542-0200
Mailing Address - Street 1:PO BOX 2500
Mailing Address - Street 2:ATTN: JOY SHIFFLETT
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22604-1700
Mailing Address - Country:US
Mailing Address - Phone:540-542-0200
Mailing Address - Fax:540-542-0318
Practice Address - Street 1:4100 PRICE CLUB BLVD
Practice Address - Street 2:ATTN: LISA MARSHALL
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112
Practice Address - Country:US
Practice Address - Phone:540-542-0200
Practice Address - Fax:540-542-0318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-17
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA230320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1720159676Medicaid