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Carolyn Elaine Beverly
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Glasgow, Virginia
NPI 1356715197

Carolyn Elaine Beverly is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Glasgow, VA. Carolyn Elaine Beverly practices in Glasgow, VA. The NPI Number for Carolyn Elaine Beverly is 1356715197 and holds a License No. 2469-01-001 (Virginia).

The current practice location address for Carolyn Elaine Beverly is 716 Fitzlee St, Glasgow, VA and can be reached out via phone at 540-258-1098.

Location: 716 Fitzlee St, Glasgow, VA, 24555-2530
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1356715197
Provider Name
Carolyn Elaine Beverly
Credential
Provider Entity Type
Individual
Gender
Female
Address
716 Fitzlee St, Glasgow, VA, 24555-2530
Phone Number
540-258-1098
Fax Number
Provider Enumeration Date
11/17/2015
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
716 Fitzlee St
City
Glasgow
State
Virginia
Zip
24555-2530
Phone Number
540-258-1098
Fax Number
person
Provider Business Mailing Address Details
Address
716 Fitzlee St
City
Glasgow
State
Virginia
Zip
24555-2530
Phone Number
540-258-1098
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
2469-01-001 (Virginia)
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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