| L R Minor Llc | |
|
910 Princess Anne St Suite 109 Fredericksburg VA 22401-5844 | |
| (540) 656-2106 | |
| (540) 656-2107 |
| Full Name | L R Minor Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 910 Princess Anne St, Fredericksburg, Virginia |
| Authorized Official Name and Position | Linda R Minor (PRESIDENT) |
| Authorized Official Contact | 5403614330 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| L R Minor Llc 910 Princess Anne St Suite 109 Fredericksburg VA 22401-5844 Ph: (540) 656-2106 | L R Minor Llc 910 Princess Anne St Suite 109 Fredericksburg VA 22401-5844 Ph: (540) 656-2106 |
| NPI Number | 1508010232 |
|---|---|
| Provider Enumeration Date | 11/07/2008 |
| Last Update Date | 11/02/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508010232 | NPI | - | NPPES |
| 291952 | Other | VA | BLUE CROSS BLUE SHIELD |
| 80000284 | Other | VA | MEDICARE ID-TYPE UNSPECIFIED |
| 089122 | Other | VA | SENTARA-VETRI |
| 512334 | Other | VA | NCPPO |
| 461682000 | Other | VA | MIS |
| 89-1497-4 | Medicaid | VA | |
| 152672 | Other | VA | MHN |
| 4763-0001 | Other | VA | CARE FIRST BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 0904002023 (Virginia) | Primary |
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