Provider Demographics
NPI:1316078629
Name:VALLEY RESIDENTIAL SERVICES, INC.
Entity type:Organization
Organization Name:VALLEY RESIDENTIAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:BEACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-865-9997
Mailing Address - Street 1:300 S SAGINAW ST
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MI
Mailing Address - Zip Code:48655-1454
Mailing Address - Country:US
Mailing Address - Phone:989-865-9997
Mailing Address - Fax:989-865-8595
Practice Address - Street 1:300 S SAGINAW ST
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MI
Practice Address - Zip Code:48655-1454
Practice Address - Country:US
Practice Address - Phone:989-865-9997
Practice Address - Fax:989-865-8595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities