| Southside Regional Medical Center | |
|
200 Medical Park Blvd Petersburg VA 23805 | |
| (804) 765-5000 | |
| (804) 765-5962 |
| Full Name | Southside Regional Medical Center |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 200 Medical Park Blvd, Petersburg, Virginia |
| Authorized Official Name and Position | Paula M Lalor (DIRECTOR/DELEGATED OFFICIAL) |
| Authorized Official Contact | 6159254565 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southside Regional Medical Center Po Box 501128 Saint Louis MO 63150-1128 Ph: () - | Southside Regional Medical Center 200 Medical Park Blvd Petersburg VA 23805 Ph: (804) 765-5000 |
| NPI Number | 1437122645 |
|---|---|
| Provider Enumeration Date | 02/08/2006 |
| Last Update Date | 08/03/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437122645 | NPI | - | NPPES |
| 442488 | Other | BCBS | |
| 4900677 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 637-04-001 (Virginia) | Primary |
Commonwealth Day Support Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 500 S Sycamore St, Petersburg, VA 23803 Phone: 804-908-4635 | |
Family Resolution Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2825 S Crater Rd, #4, Petersburg, VA 23805 Phone: 804-861-3540 Fax: 804-861-3541 | |
Spring Of Hope Therapeutic Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 325 Brown St Ste 117, Petersburg, VA 23803 Phone: 804-721-0354 | |
Family Preservation Services, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1450 Talley Ave, Petersburg, VA 23803 Phone: 804-231-1350 | |
Rizing Starz,llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 31c South Jefferson St, Petersburg, VA 23803 Phone: 804-926-5268 | |
Therapeutic In Home Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1949 Vesonder Rd, Petersburg, VA 23805 Phone: 804-640-2101 Fax: 877-879-6336 | |
Agape Angels Resoultion Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1430 Farmer St, Petersburg, VA 23803 Phone: 804-919-0364 |