Individual provider · Type 1 NPI
Carolyn Elaine Beverly
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Glasgow, VA
Practice location
716 Fitzlee St
Glasgow, VA 24555-2530
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary | 320900000X | 2469-01-001 (VA) |
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
Another provider at this address
About NPI 1356715197
Carolyn Elaine Beverly's National Provider Identifier is 1356715197, issued on Nov 17, 2015. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Glasgow, VA. The record was last updated on Nov 17, 2015.