Individual provider · Type 1 NPI
Shawana Roach
Intellectual and/or Developmental Disabilities Residential Treatment Facility · Disputanta, VA
Practice location
10424 Walton Lake Rd
Disputanta, VA 23842-4703
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary | 320600000X | 2452--01-001 (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.
Another provider at this address
About NPI 1790276186
Shawana Roach's National Provider Identifier is 1790276186, issued on May 22, 2018. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Residential Treatment Facility (320600000X), and the practice location is in Disputanta, VA. The record was last updated on May 22, 2018.