Provider Demographics
NPI:1588448419
Name:THURMAN RESIDENTIAL SERVICES LLC
Entity type:Organization
Organization Name:THURMAN RESIDENTIAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CORETTA
Authorized Official - Middle Name:LATONYA
Authorized Official - Last Name:THURMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-570-2999
Mailing Address - Street 1:2575 HAWTHORNE AVE
Mailing Address - Street 2:
Mailing Address - City:BUENA VISTA
Mailing Address - State:VA
Mailing Address - Zip Code:24416-1830
Mailing Address - Country:US
Mailing Address - Phone:540-570-2999
Mailing Address - Fax:540-572-2583
Practice Address - Street 1:2575 HAWTHORNE AVE
Practice Address - Street 2:
Practice Address - City:BUENA VISTA
Practice Address - State:VA
Practice Address - Zip Code:24416-1830
Practice Address - Country:US
Practice Address - Phone:540-570-2999
Practice Address - Fax:540-572-2583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty