Valley Community Services Board

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

Legal business name

VALLEY COMMUNITY SERVICES BOARD

Practice address

1206 Red Top Orchard Rd
Waynesboro, VA 22980-7437

Phone

(540) 887-3200

NPI assigned

Jan 19, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dana L Fitzgerald

Title

QM Director

Phone

(540) 213-7380

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Grandview Residence Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Intermediate care facility for individuals with intellectual disabilities certification: CCN 49G033

Legal name

GRANDVIEW RESIDENCE

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

Aug 25, 2004

Last certification

Jul 12, 2022

Beds

6

Ownership / control type

Private (non-profit)

Most recent change of ownership

Sep 4, 2020

Facility address

1206 Red Top Orchard Road
Waynesboro, VA 22980

Tax ID family

Grandview Residence2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Valley Community Services Board

  • Intellectual Disabilities Intermediate Care Facility
  • Staunton, VA
  • NPI 1124171376
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654819200000",
    "number": "1215080577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 SANGERS LN",
            "city": "STAUNTON",
            "state": "VA",
            "postal_code": "244016712",
            "telephone_number": "540-887-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 RED TOP ORCHARD RD",
            "city": "WAYNESBORO",
            "state": "VA",
            "postal_code": "229807437",
            "telephone_number": "540-887-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY COMMUNITY SERVICES BOARD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-10",
        "status": "A",
        "authorized_official_last_name": "FITZGERALD",
        "authorized_official_first_name": "DANA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "QM DIRECTOR",
        "authorized_official_telephone_number": "540-213-7380"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "VA",
            "license": "10501001",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010099790",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grandview Residence",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Grandview Residence",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Laura Tuomisto, ATR-BC, CTT
• Christine Marie Quilpa Turner, M.ED., NCC
• Eric Utz
• Edith Karina Valles-Cruz
• Valley Behavior Consultation Services LLC
• Valley Dermatology, LLC
• Valley Hope Counseling Center
• Valley Infusion LLC
• Valley Infusion LLC
• Valley Pastoral Counseling Center

• Intellectual Disabilities Intermediate Care Facility in Waynesboro, VA
• Providers in Waynesboro, VA by specialty
• Intellectual Disabilities Intermediate Care Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.