Provider Demographics
NPI:1558635177
Name:BEDFORD COUNTY GROUP HOMES
Entity Type:Organization
Organization Name:BEDFORD COUNTY GROUP HOMES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MORGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CONNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-586-1978
Mailing Address - Street 1:1185 TURNING POINT RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:VA
Mailing Address - Zip Code:24523-3465
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1185 TURNING POINT RD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:VA
Practice Address - Zip Code:24523-3465
Practice Address - Country:US
Practice Address - Phone:540-586-1978
Practice Address - Fax:540-586-5465
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BEDFORD COUNTY SOCIAL SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-02-29
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VACO-389-11320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness