Basic Information
| Provider Information | |||||||||
| NPI: | 1730239922 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GRAFTON SCHOOL, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2500 | ||||||||
| Address2: | FINANCE | ||||||||
| City: | WINCHESTER | ||||||||
| State: | VA | ||||||||
| PostalCode: | 226041700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5405420200 | ||||||||
| FaxNumber: | 5405420200 | ||||||||
| Practice Location | |||||||||
| Address1: | 801 CHILDRENS CENTER RD SW | ||||||||
| Address2: | |||||||||
| City: | LEESBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 201752545 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7037773485 | ||||||||
| FaxNumber: | 7037774887 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/11/2007 | ||||||||
| LastUpdateDate: | 10/18/2011 | ||||||||
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| AuthorizedOfficialLastName: | LANE | ||||||||
| AuthorizedOfficialFirstName: | VANESSA | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR, ACCOUNTS RECEIVABLE | ||||||||
| AuthorizedOfficialTelephone: | 5405420200 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 323P00000X | 030-14-001 | VA | Y | Residential Treatment Facilities | Psychiatric Residential Treatment Facility |
ID Information
| ID | Type | State | Issuer | Description | 000207039 | 05 | VA | MEDICAID | 030613300 | 05 | DC | MEDICAID |