OrganizationActive
Mountain Laurel Group LLC
NPI 1992853436 · Emotionally Disturbed Childrens' Residential Treatment Facility · Culpeper, VA
Provider details
- NPI number
- 1992853436
- Entity type
- Organization
- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment FacilityResidential Treatment Facilities
- Authorized official
- Bruce Wyman, Director/Ceo
- License
- 993-14-001 (VA)
Practice location
102 N Main St Ste 300
Culpeper, VA 22701-3053
Phone: (540) 829-1789
Fax: (540) 829-0117
Mailing address
102 N Main St Ste 300
Culpeper, VA 22701-3053
Registry dates
- Enumerated
- 2007-01-08
- Last updated
- 2012-01-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.