Provider Demographics
NPI:1730239922
Name:GRAFTON SCHOOL, INC.
Entity type:Organization
Organization Name:GRAFTON SCHOOL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, ACCOUNTS RECEIVABLE
Authorized Official - Prefix:MRS
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:LANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-542-0200
Mailing Address - Street 1:PO BOX 2500
Mailing Address - Street 2:FINANCE
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22604-1700
Mailing Address - Country:US
Mailing Address - Phone:540-542-0200
Mailing Address - Fax:540-542-0200
Practice Address - Street 1:801 CHILDRENS CENTER RD SW
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20175-2545
Practice Address - Country:US
Practice Address - Phone:703-777-3485
Practice Address - Fax:703-777-4887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA030-14-001323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA000207039Medicaid
DC030613300Medicaid