Provider Demographics
NPI:1548499304
Name:UNITED METHODIST FAMILY SERVICES OF VIRGINIA
Entity type:Organization
Organization Name:UNITED METHODIST FAMILY SERVICES OF VIRGINIA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF PROGRAMS
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARCY
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-353-4461
Mailing Address - Street 1:3900 W BROAD ST
Mailing Address - Street 2:BUILDING 10
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-3958
Mailing Address - Country:US
Mailing Address - Phone:804-353-4461
Mailing Address - Fax:804-239-1242
Practice Address - Street 1:5400 SHAWNEE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22312-2300
Practice Address - Country:US
Practice Address - Phone:703-941-9008
Practice Address - Fax:703-750-0621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-14
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA19305001253Z00000X
VA03205376251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No253Z00000XAgenciesIn Home Supportive Care