NPI | 1740412071 |
---|---|
Doing Business As | 180 BOYS ADOLESCENT GROUP HOME |
Entity Type | Organization |
Authorized Contact | MARVIN VAN ROANE President/CEO 804-349-6382 |
Organization Subpart ? | No |
Primary Taxonomy | 103TP2701X Psychologist, Group Psychotherapy |
Enumeration Date | 2009-08-20 |
Last Update Date | 2009-08-20 |