Provider Demographics
NPI:1700926029
Name:ALTAVISTA ADULT DAY CARE CENTER. INC
Entity Type:Organization
Organization Name:ALTAVISTA ADULT DAY CARE CENTER. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:TALBOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-656-3114
Mailing Address - Street 1:PO BOX 545
Mailing Address - Street 2:
Mailing Address - City:ALTAVISTA
Mailing Address - State:VA
Mailing Address - Zip Code:24517-0545
Mailing Address - Country:US
Mailing Address - Phone:434-656-3114
Mailing Address - Fax:
Practice Address - Street 1:103 AVOCA LN
Practice Address - Street 2:
Practice Address - City:ALTAVISTA
Practice Address - State:VA
Practice Address - Zip Code:24517-1154
Practice Address - Country:US
Practice Address - Phone:434-656-3114
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care