| NPI | 1649317918 |
|---|---|
| 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 406-14-003) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2020-08-22 |