Provider Demographics
NPI:1710905179
Name:SHENANDOAH VALLEY COMMUNITY RESIDENCES, INC.
Entity Type:Organization
Organization Name:SHENANDOAH VALLEY COMMUNITY RESIDENCES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:H
Authorized Official - Last Name:COMBS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:540-722-4900
Mailing Address - Street 1:20 E PICCADILLY ST
Mailing Address - Street 2:SUITE 7
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-4869
Mailing Address - Country:US
Mailing Address - Phone:540-722-4900
Mailing Address - Fax:540-722-4909
Practice Address - Street 1:20 E PICCADILLY ST
Practice Address - Street 2:SUITE 7
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-4869
Practice Address - Country:US
Practice Address - Phone:540-722-4900
Practice Address - Fax:540-722-4909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities