Provider Demographics
NPI:1194451237
Name:MELISSA ROBBINS
Entity type:Organization
Organization Name:MELISSA ROBBINS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SERVICE FACILITATOR
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBBINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-780-2393
Mailing Address - Street 1:643 BROOKS LN
Mailing Address - Street 2:
Mailing Address - City:SUGAR GROVE
Mailing Address - State:VA
Mailing Address - Zip Code:24375-3187
Mailing Address - Country:US
Mailing Address - Phone:276-780-2393
Mailing Address - Fax:877-840-5216
Practice Address - Street 1:643 BROOKS LN
Practice Address - Street 2:
Practice Address - City:SUGAR GROVE
Practice Address - State:VA
Practice Address - Zip Code:24375-3187
Practice Address - Country:US
Practice Address - Phone:276-780-2393
Practice Address - Fax:877-840-5216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-30
Last Update Date:2022-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1619628872Medicaid