Provider Demographics
NPI:1144313925
Name:VALLEY ASSOCIATES FOR INDEPENDENT LIVING, INC.
Entity type:Organization
Organization Name:VALLEY ASSOCIATES FOR INDEPENDENT LIVING, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GAYL
Authorized Official - Middle Name:C
Authorized Official - Last Name:BRUNK
Authorized Official - Suffix:
Authorized Official - Credentials:BSW
Authorized Official - Phone:540-433-6513
Mailing Address - Street 1:3210 PEOPLES DRIVE SUITE 220
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801
Mailing Address - Country:US
Mailing Address - Phone:540-433-6513
Mailing Address - Fax:540-433-6313
Practice Address - Street 1:3210 PEOPLES DRIVE SUITE 220
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801
Practice Address - Country:US
Practice Address - Phone:540-433-6513
Practice Address - Fax:540-433-6313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA251B00000X
251C00000X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
No251B00000XAgenciesCase ManagementGroup - Single Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1144313925Medicaid
VA008743444Medicaid
VA008743495Medicaid
VA004946545Medicaid