Provider Demographics
NPI:1376042523
Name:DANVILLE PITTSYLVANIA COMMUNITY SERVICES
Entity Type:Organization
Organization Name:DANVILLE PITTSYLVANIA COMMUNITY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:FREDRICK
Authorized Official - Last Name:BEBEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-799-0456
Mailing Address - Street 1:245 HAIRSTON ST
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24540-4137
Mailing Address - Country:US
Mailing Address - Phone:434-799-0456
Mailing Address - Fax:
Practice Address - Street 1:505 KEEN ST
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540-4657
Practice Address - Country:US
Practice Address - Phone:434-799-0456
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DANVILLE PITTSYLVANIA COMMUNITY SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-02-02
Last Update Date:2018-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities