Provider Demographics
NPI:1750504833
Name:RAPPAHANNOCK RAPIDAN CSB
Entity Type:Organization
Organization Name:RAPPAHANNOCK RAPIDAN CSB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:LAGRAFFE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-825-3100
Mailing Address - Street 1:PO BOX 1568
Mailing Address - Street 2:
Mailing Address - City:CULPEPER
Mailing Address - State:VA
Mailing Address - Zip Code:22701-6568
Mailing Address - Country:US
Mailing Address - Phone:540-825-3100
Mailing Address - Fax:540-825-6245
Practice Address - Street 1:15361 BRADFORD RD
Practice Address - Street 2:
Practice Address - City:CULPEPER
Practice Address - State:VA
Practice Address - Zip Code:22701-4238
Practice Address - Country:US
Practice Address - Phone:540-825-3100
Practice Address - Fax:540-825-6245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA4978374225100000X
252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA188999OtherANTHEM - PT