Provider Demographics
NPI:1629587456
Name:RADFORD UNIVERSITY
Entity Type:Organization
Organization Name:RADFORD UNIVERSITY
Other - Org Name:INFANT & TODDLER CONNECTION OF THE NEW RIVER VALLEY - RU
Other - Org Type:Other Name
Authorized Official - Title/Position:SYSTEM MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:PIERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-831-7529
Mailing Address - Street 1:P.O. BOX 7006
Mailing Address - Street 2:
Mailing Address - City:RADFORD
Mailing Address - State:VA
Mailing Address - Zip Code:24142
Mailing Address - Country:US
Mailing Address - Phone:540-831-7529
Mailing Address - Fax:540-831-6908
Practice Address - Street 1:801 EAST MAIN STREET
Practice Address - Street 2:
Practice Address - City:RADFORD
Practice Address - State:VA
Practice Address - Zip Code:24142
Practice Address - Country:US
Practice Address - Phone:540-831-7529
Practice Address - Fax:540-831-6908
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RADFORD UNIVERSITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-09-25
Last Update Date:2017-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency