Provider Demographics
NPI:1992738942
Name:CHILD HEALTH INVESTMENT PARTNERSHIP
Entity type:Organization
Organization Name:CHILD HEALTH INVESTMENT PARTNERSHIP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIR. OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:G
Authorized Official - Last Name:BRADNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-857-6993
Mailing Address - Street 1:1201- 3RD ST., SW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24016-4611
Mailing Address - Country:US
Mailing Address - Phone:540-857-6993
Mailing Address - Fax:540-857-6999
Practice Address - Street 1:1201- 3RD ST., SW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24016-4611
Practice Address - Country:US
Practice Address - Phone:540-857-6993
Practice Address - Fax:540-857-6999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAVA009600507251B00000X, 251E00000X, 251K00000X
VA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health
No251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAVA009600507Medicaid