Commonwealth of Virginia Department of Behavi

NPI #1114027521 in Williamsburg, Virginia

Provider Information

NPI Number: 1114027521
Entity Type: Organization
Organization Name: Commonwealth of Virginia Department of Behavi
Subpart: Yes (part of a larger organization)
Parent Organization: COMMONWEALTH OF VIRGINIA DEPARTMENT OF BEHAVIORAL HEALTH AN
Primary Specialty: Intermediate Care Facility, Mental Illness
Enumeration Date: Sep 25, 2006
Last Updated: Jun 6, 2011

Practice Location

Address: 4601 IRONBOUND RD
City: Williamsburg
State: Virginia
ZIP Code: 23188-2652
Phone: (757) 253-5241

Authorized Official

Name: MR. JACK L.. WOOD, NHA
Title: HOSPITAL DIRECTOR
Phone: (757) 253-5241

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Intermediate Care Facility, Mental Illness	310500000X	Primary

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