Provider Demographics
NPI:1174970941
Name:BLUE RIDGE CAREGIVERS, INC.
Entity type:Organization
Organization Name:BLUE RIDGE CAREGIVERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARY PAT
Authorized Official - Middle Name:
Authorized Official - Last Name:HOADLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-825-1819
Mailing Address - Street 1:PO BOX 819
Mailing Address - Street 2:
Mailing Address - City:CULPEPER
Mailing Address - State:VA
Mailing Address - Zip Code:22701-0819
Mailing Address - Country:US
Mailing Address - Phone:540-825-1819
Mailing Address - Fax:540-825-1716
Practice Address - Street 1:17191 TATTERSHALL WAY
Practice Address - Street 2:
Practice Address - City:JEFFERSONTON
Practice Address - State:VA
Practice Address - Zip Code:22724-1786
Practice Address - Country:US
Practice Address - Phone:540-825-1819
Practice Address - Fax:540-825-1716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-20
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-161162253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0175219002OtherAPI