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ROANOKE RESOURCE LLC NPI 1104170679


NPI Information

NPI: 1104170679
Provider Name: ROANOKE RESOURCE LLC
Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization

CLIA Number: 49D2217511

Address:
402 CAMPBELL AVE SW
ROANOKE, VA
ZIP 24016
Phone: (540) 400-7431
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ROANOKE RESOURCE LLC is a community behavioral health in Roanoke, VA. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. ROANOKE RESOURCE LLC NPI is 1104170679. The provider is registered as an organization entity type.

The provider's business location address is:

402 CAMPBELL AVE SW
ROANOKE, VA
ZIP 24016-627
Phone: (540) 400-7431
Fax: (540) 400-7091

The provider's authorized official is Celia Lea Mccauley-wittl .
The authorized official title is Operations Coordinator and has the following contact phone number (540) 400-7431.

The CLIA number assigned to this NPI record is 49D2217511 - other - behavioral health with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/5/2012 and was last updated on 12/11/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1253Z00000XIn Home Supportive CareNo
2251S00000XCommunity/Behavioral HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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