Provider Demographics
NPI:1245487834
Name:VIRGINIA BAPTIST CHILDRENS HOME AND FAMILY SERVICES
Entity type:Organization
Organization Name:VIRGINIA BAPTIST CHILDRENS HOME AND FAMILY SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-389-5468
Mailing Address - Street 1:860 MOUNT VERNON LN
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-2700
Mailing Address - Country:US
Mailing Address - Phone:540-389-5468
Mailing Address - Fax:540-389-5570
Practice Address - Street 1:860 MOUNT VERNON LN
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-2700
Practice Address - Country:US
Practice Address - Phone:540-389-5468
Practice Address - Fax:540-389-5570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-26
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VACO-6-10322D00000X
VASS-06-07253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children