| Upside To Youth Development Llc | |
|
320 E Broadway Suite 205 Hopewell VA 23860-2812 | |
| (804) 541-7894 | |
| (804) 541-7895 |
| Full Name | Upside To Youth Development Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 320 E Broadway, Hopewell, Virginia |
| Authorized Official Name and Position | Brandon C Hudson (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 8045417894 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Upside To Youth Development Llc 320 E Broadway Suite 205 Hopewell VA 23860-2812 Ph: (804) 541-7894 | Upside To Youth Development Llc 320 E Broadway Suite 205 Hopewell VA 23860-2812 Ph: (804) 541-7894 |
| NPI Number | 1790094340 |
|---|---|
| Provider Enumeration Date | 09/30/2010 |
| Last Update Date | 09/30/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790094340 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 1082 (Virginia) | Primary |
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