Provider Demographics
NPI:1235557042
Name:ORLANDO'S PLACE, LLC
Entity Type:Organization
Organization Name:ORLANDO'S PLACE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:B
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:BA PSYCHOLOGY
Authorized Official - Phone:540-412-6749
Mailing Address - Street 1:4510 PLANK RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-0138
Mailing Address - Country:US
Mailing Address - Phone:540-412-6749
Mailing Address - Fax:540-412-6750
Practice Address - Street 1:4510 PLANK RD
Practice Address - Street 2:SUITE 203
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-0138
Practice Address - Country:US
Practice Address - Phone:540-412-6749
Practice Address - Fax:540-412-6750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-31
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1890-02-006251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health