NPI | 1407993777 |
---|---|
Doing Business As | DOMINION YOUTH SERVICES RESIDENTIAL LLC |
Entity Type | Organization |
Authorized Contact | GL PULLIAM Director Of Residential 804-285-9838 |
Organization Subpart ? | No |
Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: VA 406-14-001) |
Enumeration Date | 2007-01-30 |
Last Update Date | 2020-08-22 |