Provider Demographics
NPI:1457596777
Name:GAFFNEY COMMUNITY CARE
Entity Type:Organization
Organization Name:GAFFNEY COMMUNITY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORRI
Authorized Official - Middle Name:L
Authorized Official - Last Name:GAFFNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-961-4650
Mailing Address - Street 1:5541 PARLIAMENT DR
Mailing Address - Street 2:101
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-3300
Mailing Address - Country:US
Mailing Address - Phone:757-961-4650
Mailing Address - Fax:757-961-4654
Practice Address - Street 1:5541 PARLIAMENT DR
Practice Address - Street 2:101
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-3300
Practice Address - Country:US
Practice Address - Phone:757-961-4650
Practice Address - Fax:757-961-4654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-16
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes385H00000XRespite Care FacilityRespite Care
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0103305642Medicaid