Provider Demographics
NPI:1427355908
Name:FRANCISCAN BRETHREN OF ST PHILIP
Entity type:Organization
Organization Name:FRANCISCAN BRETHREN OF ST PHILIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARGARETWALUBUKA
Authorized Official - Middle Name:
Authorized Official - Last Name:WALUBUKA
Authorized Official - Suffix:
Authorized Official - Credentials:QMRP
Authorized Official - Phone:757-256-6937
Mailing Address - Street 1:PO BOX 1356
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23187-1356
Mailing Address - Country:US
Mailing Address - Phone:757-208-0224
Mailing Address - Fax:757-208-0348
Practice Address - Street 1:6422 CENTERVILLE RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-1739
Practice Address - Country:US
Practice Address - Phone:757-208-0224
Practice Address - Fax:757-208-0349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-18
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA750-02-006251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services