Provider Demographics
NPI:1265535611
Name:BOTETOURT COUNSELING CENTER INC
Entity type:Organization
Organization Name:BOTETOURT COUNSELING CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTGOMERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-977-6300
Mailing Address - Street 1:3522 WEBSTER ROAD
Mailing Address - Street 2:
Mailing Address - City:BLUE RIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:24064
Mailing Address - Country:US
Mailing Address - Phone:540-977-6300
Mailing Address - Fax:540-977-9523
Practice Address - Street 1:3522 WEBSTER ROAD
Practice Address - Street 2:
Practice Address - City:BLUE RIDGE
Practice Address - State:VA
Practice Address - Zip Code:24064
Practice Address - Country:US
Practice Address - Phone:540-977-6300
Practice Address - Fax:540-977-9523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)