Provider Demographics
NPI:1255779674
Name:RIDGE PLACE FAMILY SERVICES LLC
Entity type:Organization
Organization Name:RIDGE PLACE FAMILY SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATTIE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:QHMP
Authorized Official - Phone:804-382-1151
Mailing Address - Street 1:8115 WESTMEATH LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23227-1717
Mailing Address - Country:US
Mailing Address - Phone:804-382-1151
Mailing Address - Fax:804-562-3224
Practice Address - Street 1:5910 RIDGE RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23227-1933
Practice Address - Country:US
Practice Address - Phone:804-382-1151
Practice Address - Fax:804-562-3224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-07
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1848-01-001320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities