1184408056 NPI number — BRAIN INJURY CONNECTIONS OF THE SHENANDOAH VALLEY

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184408056 NPI number — BRAIN INJURY CONNECTIONS OF THE SHENANDOAH VALLEY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BRAIN INJURY CONNECTIONS OF THE SHENANDOAH VALLEY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1184408056
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
755 MARTIN LUTHER KING, JR. WAY
Provider Second Line Business Mailing Address:
MSC 9020
Provider Business Mailing Address City Name:
HARRISONBURG
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22807
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-568-8923
Provider Business Mailing Address Fax Number:
540-492-5587

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
755 MARTIN LUTHER KING, JR. WAY
Provider Second Line Business Practice Location Address:
MSC 9020
Provider Business Practice Location Address City Name:
HARRISONBURG
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22807
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-568-8923
Provider Business Practice Location Address Fax Number:
540-492-5587
Provider Enumeration Date:
08/22/2023

Additional Information

Authorized Official

Authorized Official Last Name:
WEAKLEY
Authorized Official First Name:
STACEY
Authorized Official Middle Name:
LEE
Authorized Official Title or Position:
ADMINISTRATIVE DIRECTOR
Authorized Official Telephone Number:
540-568-8923

Provider Taxonomy Codes

  • Taxonomy code: 2084P0301X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com