Provider Demographics
NPI:1548998503
Name:CARE CONNECT OF VIRGINIA, LLC
Entity type:Organization
Organization Name:CARE CONNECT OF VIRGINIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:SPANGLER
Authorized Official - Last Name:LEONARD
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:540-208-1812
Mailing Address - Street 1:4658 BRAMBLETON AVE
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-3437
Mailing Address - Country:US
Mailing Address - Phone:540-208-1812
Mailing Address - Fax:540-301-0769
Practice Address - Street 1:4658 BRAMBLETON AVE
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-3437
Practice Address - Country:US
Practice Address - Phone:540-208-1812
Practice Address - Fax:540-301-0769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-09
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services