| Specialized Youth Services Of Va, Inc | |
|
230 S Crater Rd Petersburg VA 23803-4424 | |
| (804) 733-2180 | |
| (804) 733-8502 |
| Full Name | Specialized Youth Services Of Va, Inc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 230 S Crater Rd, Petersburg, Virginia |
| Authorized Official Name and Position | Warren G Bull (OWNER) |
| Authorized Official Contact | 8047332180 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Specialized Youth Services Of Va, Inc 230 S Crater Rd Petersburg VA 23803-4424 Ph: (804) 733-2180 | Specialized Youth Services Of Va, Inc 230 S Crater Rd Petersburg VA 23803-4424 Ph: (804) 733-2180 |
| NPI Number | 1811022361 |
|---|---|
| Provider Enumeration Date | 02/23/2007 |
| Last Update Date | 10/15/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811022361 | NPI | - | NPPES |
| 1780872101 | Other | VA | NPI |
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