Basic Information
| Provider Information | |||||||||
| NPI: | 1619540994 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | GRAFTON SCHOOL, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2500 | ||||||||
| Address2: | |||||||||
| City: | WINCHESTER | ||||||||
| State: | VA | ||||||||
| PostalCode: | 226041700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5405420200 | ||||||||
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| Practice Location | |||||||||
| Address1: | 224 KRAYS MILL RD | ||||||||
| Address2: | |||||||||
| City: | COLD SPRING | ||||||||
| State: | MN | ||||||||
| PostalCode: | 563204563 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5405420200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/23/2021 | ||||||||
| LastUpdateDate: | 07/23/2021 | ||||||||
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| AuthorizedOfficialLastName: | LANE | ||||||||
| AuthorizedOfficialFirstName: | VANESSA | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CHIEF ADMINISTRATIVE OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 5405420200 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | GRAFTON SCHOOL, INC. | ||||||||
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| NPICertificationDate: | 07/23/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 323P00000X | Y | Residential Treatment Facilities | Psychiatric Residential Treatment Facility |
No ID Information.