Individual provider · Type 1 NPI
Tiffany T. Russell
Intellectual and/or Developmental Disabilities Residential Treatment Facility · Dry Fork, VA
Practice location
6245 Dry Fork Rd
Dry Fork, VA 24549-4139
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary | 320600000X | 11862 (VA) |
Intellectual and/or Developmental Disabilities Residential Treatment Facility: A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
About NPI 1437026358
Tiffany T. Russell's National Provider Identifier is 1437026358, issued on Oct 23, 2025. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Residential Treatment Facility (320600000X), and the practice location is in Dry Fork, VA. The record was last updated on Oct 24, 2025.