OrganizationActive
Community Connection Support Services, LLC
NPI 1770035750 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Galax, VA
Provider details
- NPI number
- 1770035750
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Cheryl Grimm, Director(276) 233-2817
- License
- 2754-08-011 (VA)
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000XLicense 2754-08-011 (VA)
Residential Treatment Facilities
Practice location
2460 Hebron Rd
Galax, VA 24333-5280
Phone: (276) 233-2817
Fax: (800) 866-3885
Approximate (ZIP-level) locationGet directions
Mailing address
2460 Hebron Rd
Galax, VA 24333-5280
Registry dates
- Enumerated
- 2016-10-26
- Last updated
- 2016-10-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.