| NPI | 1063628170 |
|---|---|
| Doing Business As | RICHMOND SOUTHSIDE TREATMENT CENTER |
| Entity Type | Organization |
| Authorized Contact | RODNEY WILLIAMS CFO 407-351-7080 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
| Additional Taxonomies | 251S00000X (Licence: VA 362-06-002) |
| 3336C0002X Pharmacy, Clinic Pharmacy (Licence: VA 00201003977) | |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2019-10-10 |