Provider Demographics
NPI:1962763300
Name:SPARROWS REST
Entity type:Organization
Organization Name:SPARROWS REST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:BOWERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-738-2044
Mailing Address - Street 1:53 SEVEN SPRINGS LN
Mailing Address - Street 2:
Mailing Address - City:BRIGHTWOOD
Mailing Address - State:VA
Mailing Address - Zip Code:22715-1566
Mailing Address - Country:US
Mailing Address - Phone:540-738-2044
Mailing Address - Fax:
Practice Address - Street 1:53 SEVEN SPRINGS LN
Practice Address - Street 2:
Practice Address - City:BRIGHTWOOD
Practice Address - State:VA
Practice Address - Zip Code:22715-1566
Practice Address - Country:US
Practice Address - Phone:540-738-2044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-01
Last Update Date:2012-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health