Provider Demographics
NPI:1598974669
Name:UNITED METHODIST FAMILY SERVICES
Entity Type:Organization
Organization Name:UNITED METHODIST FAMILY SERVICES
Other - Org Name:LELAND HOUSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIEHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-254-9469
Mailing Address - Street 1:13525 LELAND RD
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20120-2037
Mailing Address - Country:US
Mailing Address - Phone:703-222-3558
Mailing Address - Fax:703-803-7130
Practice Address - Street 1:13525 LELAND RD
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:VA
Practice Address - Zip Code:20120-2037
Practice Address - Country:US
Practice Address - Phone:703-222-3558
Practice Address - Fax:703-803-7130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2013-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA64114001322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010386241Medicaid