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Mrs. Stephanie A Moon
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Crozet, Virginia
NPI 1497199541

Stephanie A Moon is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Crozet, VA. Stephanie A Moon practices in Crozet, VA. The NPI Number for Stephanie A Moon is 1497199541 and holds a License No. (Virginia).

The current practice location address for Stephanie A Moon is 1675 Buck Rd, Crozet, VA and can be reached out via phone at 434-205-4333 and via fax at 434-205-4016.

Location: 1675 Buck Rd, Crozet, VA, 22932-2720
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1497199541
Provider Name
Stephanie A Moon
Credential
Provider Entity Type
Individual
Gender
Female
Address
1675 Buck Rd, Crozet, VA, 22932-2720
Phone Number
434-205-4333
Fax Number
434-205-4016
Provider Enumeration Date
04/19/2013
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
274236485 01 VA FEDERAL I D
institution
Provider Business Practice Location Address Details
Address
1675 Buck Rd
City
Crozet
State
Virginia
Zip
22932-2720
Phone Number
434-205-4333
Fax Number
434-205-4016
person
Provider Business Mailing Address Details
Address
1675 Buck Rd
City
Crozet
State
Virginia
Zip
22932-2720
Phone Number
434-205-4333
Fax Number
434-205-4016
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.
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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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