Provider Demographics
NPI:1346486024
Name:LUTHERAN FAMILY SERVICES OF VIRGINIA, INC.
Entity Type:Organization
Organization Name:LUTHERAN FAMILY SERVICES OF VIRGINIA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FREIDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-774-7100
Mailing Address - Street 1:2609 MCVITTY RD
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-3513
Mailing Address - Country:US
Mailing Address - Phone:540-774-7100
Mailing Address - Fax:540-774-1084
Practice Address - Street 1:48 S PURCELL AVE
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-5557
Practice Address - Country:US
Practice Address - Phone:540-450-2782
Practice Address - Fax:540-450-2783
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LUTHERAN FAMILY SERVICES OF VIRGINIA, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-12-30
Last Update Date:2008-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA272-02-029251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services