Southside Virginia Training Center

NPI 1154330942 - Intermediate Care Facility, Mentally Retarded - 315P00000X

NPI Details
NPI 1154330942
Enumeration Date 08/08/2006
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name JOHN ALFRED JOHN
Position FACILITY DIRECTOR
Phone (804) 524-7209
Fax (804) 524-7228
Practice Location
26317 WEST WASHINGTON STREET
PETERSBURG VA, 23803, US
Phone (804) 524-7209
Fax (804) 524-7228
Business Location
26317 WEST WASHINGTON STREET
PETERSBURG VA, 23803, US
Phone (804) 524-7209
Fax (804) 524-7228
Toxanomy
Taxonomy Code 315P00000X
License State
License Number
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According to our database, Southside Virginia Training Center NPI is 1154330942, taxonomy code is 315P00000X Southside Virginia Training Center physically located at 26317 West Washington Street, Petersburg VA, 23803. NPI Number 1033115704 has the healthcare provider type.

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1154330942 NPI number is provided on an as is basis without warranty of any kind. 1154330942 is maintained by the National Plan & Provider Enumeration System. The contents of Southside Virginia Training Center are for informational purposes only.