Provider Demographics
NPI:1487081337
Name:BRANCHES OF LIFE
Entity type:Organization
Organization Name:BRANCHES OF LIFE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:WENDI
Authorized Official - Middle Name:
Authorized Official - Last Name:STRICKLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-426-3257
Mailing Address - Street 1:110 OLD BERMUDA HUNDRED RD
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23836-5609
Mailing Address - Country:US
Mailing Address - Phone:804-571-6687
Mailing Address - Fax:804-571-6692
Practice Address - Street 1:110 OLD BERMUDA HUNDRED RD
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23836-5609
Practice Address - Country:US
Practice Address - Phone:804-571-6687
Practice Address - Fax:804-571-6692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-07
Last Update Date:2013-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2130-02-006251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services