Provider Demographics
NPI:1477705176
Name:REAVES-DIGGS, PARHAM & ASSOCIATES, LLC
Entity Type:Organization
Organization Name:REAVES-DIGGS, PARHAM & ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:TRACCINNIEA
Authorized Official - Last Name:REAVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-237-5005
Mailing Address - Street 1:PO BOX 2513
Mailing Address - Street 2:LYNCHBURG
Mailing Address - City:VIRGINIA BCH
Mailing Address - State:VA
Mailing Address - Zip Code:23450-2513
Mailing Address - Country:US
Mailing Address - Phone:434-237-5005
Mailing Address - Fax:434-237-5535
Practice Address - Street 1:147 MILL RIDGE RD STE 203
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-4341
Practice Address - Country:US
Practice Address - Phone:434-237-5005
Practice Address - Fax:434-237-5535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-14
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VASS-04-47322D00000X
VASS-381/4271-08322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children