Annzetta's Therapeutic Home For Boys, Llc

NPI 1063609659 - Community Based Residential Treatment Facility, Mental Illness - 320800000X

NPI Details
NPI 1063609659
Enumeration Date 09/27/2007
Last Updated 10/25/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name MARY EMMA MARY
Position OFFICE CLERK
Phone (804) 863-2661
Fax
Practice Location
1834 BUCKNER ST
PETERSBURG VA, 23805-1705, US
Phone (804) 863-2661
Fax
Business Location
1834 BUCKNER ST
PETERSBURG VA, 23805-1705, US
Phone (804) 863-2661
Fax
Toxanomy
Taxonomy Code 320800000X
License State
License Number
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According to our database, Annzetta's Therapeutic Home For Boys, Llc NPI is 1063609659, taxonomy code is 320800000X Annzetta's Therapeutic Home For Boys, Llc physically located at 1834 Buckner St, Petersburg VA, 23805-1705. NPI Number 1033115704 has the healthcare provider type.

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1063609659 NPI number is provided on an as is basis without warranty of any kind. 1063609659 is maintained by the National Plan & Provider Enumeration System. The contents of Annzetta's Therapeutic Home For Boys, Llc are for informational purposes only.