| Caroline Outpatient Program | |
|
7120 Conway Place Ruther Glen VA 22546 | |
| (804) 305-5954 | |
| Not Available |
| Full Name | Caroline Outpatient Program |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 7120 Conway Place, Ruther Glen, Virginia |
| Authorized Official Name and Position | Sheronda W. Wingo (CEO/DIRECTOR) |
| Authorized Official Contact | 8045890022 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Caroline Outpatient Program Po Box 615 Ladysmith VA 22501-0615 Ph: (804) 305-5954 | Caroline Outpatient Program 7120 Conway Place Ruther Glen VA 22546 Ph: (804) 305-5954 |
| NPI Number | 1346423225 |
|---|---|
| Provider Enumeration Date | 12/13/2007 |
| Last Update Date | 12/13/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346423225 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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