Provider Demographics
NPI:1689125767
Name:VIRGINIA BAPTIST CHILDREN'S HOME AND FAMILY SERVICES
Entity Type:Organization
Organization Name:VIRGINIA BAPTIST CHILDREN'S HOME AND FAMILY SERVICES
Other - Org Name:HOPETREE FAMILY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHERSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:540-389-5468
Mailing Address - Street 1:PO BOX 849
Mailing Address - Street 2:860 MT VERNON LANE
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-0849
Mailing Address - Country:US
Mailing Address - Phone:540-389-5468
Mailing Address - Fax:540-389-5570
Practice Address - Street 1:107 CLEARVIEW DR
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112-1501
Practice Address - Country:US
Practice Address - Phone:276-790-3720
Practice Address - Fax:276-790-3725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-24
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VACPA13253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA600890419Medicaid