Provider Demographics
NPI:1346418316
Name:ELK HILL FARM, INC.
Entity Type:Organization
Organization Name:ELK HILL FARM, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:FARLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:804-457-4866
Mailing Address - Street 1:PO BOX 99
Mailing Address - Street 2:
Mailing Address - City:GOOCHLAND
Mailing Address - State:VA
Mailing Address - Zip Code:23063-0099
Mailing Address - Country:US
Mailing Address - Phone:804-457-4866
Mailing Address - Fax:804-457-2830
Practice Address - Street 1:1975 ELK HILL ROAD
Practice Address - Street 2:
Practice Address - City:GOOCHLAND
Practice Address - State:VA
Practice Address - Zip Code:23063
Practice Address - Country:US
Practice Address - Phone:804-457-4866
Practice Address - Fax:804-457-2830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-13
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X
VASS19405322D00000X
VASS25005322D00000X
VASS38007322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
No251S00000XAgenciesCommunity/Behavioral Health