Provider Demographics
NPI:1437879558
Name:VIRGINIA BAPTIST CHILDREN'S HOME & FAMILY SERVICES
Entity Type:Organization
Organization Name:VIRGINIA BAPTIST CHILDREN'S HOME & FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF CLINICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHALLEN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MABRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-389-5468
Mailing Address - Street 1:860 MOUNT VERNON LN
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-2700
Mailing Address - Country:US
Mailing Address - Phone:540-493-4480
Mailing Address - Fax:
Practice Address - Street 1:860 MOUNT VERNON LN
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-2700
Practice Address - Country:US
Practice Address - Phone:540-493-4480
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No253J00000XAgenciesFoster Care Agency
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children