NPI 1093794877

Southside Virginia Traninng Center

Organisation Intellectual and/or Developmental Disabilities Residential Treatment Facility Petersburg, VA

Practice location

Address: 26317 W Washington St, Petersburg, VA 23803-0030
Phone: (804) 524-7209
Fax: (804) 524-7228
Mailing address: PO Box 4030, Petersburg, VA 23803-0030

Authorised official

Name: John A. Holland
Title: Facility Director
Phone: (804) 524-7209

Registered specialties

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320600000X Licence 28892 (VA)

Other Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in Virginia →

Registry record

NPI: 1093794877
Entity type: Organization
NPI issued: 11 Jan 2006
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.