Provider Demographics
NPI:1245517440
Name:CENTRAL VIRGINIA HEALTHCARE ASSOCIATION, LLC
Entity type:Organization
Organization Name:CENTRAL VIRGINIA HEALTHCARE ASSOCIATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIONA
Authorized Official - Middle Name:MELVIN
Authorized Official - Last Name:SHEFFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-218-8218
Mailing Address - Street 1:1674 MIDVIEW RD
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23231-5700
Mailing Address - Country:US
Mailing Address - Phone:804-218-8218
Mailing Address - Fax:
Practice Address - Street 1:1674 MIDVIEW RD
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23231-5700
Practice Address - Country:US
Practice Address - Phone:804-218-8218
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-16
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1864251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1295021178Medicaid