NPI 1104006055

Hampton Roads Youth Center

Organisation Emotionally Disturbed Childrens' Residential Treatment Facility Suffolk, VA

Practice location

Address: 275 Kenyon Rd Suite B, Suffolk, VA 23434-7450
Phone: (757) 923-4948
Fax: (757) 923-4949
Mailing address: 275 Kenyon Rd, Suffolk, VA 23434-7450

Authorised official

Name: Denise Rae Mullins
Title: Chief Executive Officer
Phone: (757) 923-4948

Registered specialties

Emotionally Disturbed Childrens' Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 322D00000X Licence SS-241-06 (VA)

Other Residential Treatment Facility, Emotionally Disturbed Children providers in Virginia →

Registry record

NPI: 1104006055
Entity type: Organization
NPI issued: 8 Nov 2007
Record last updated: 8 Nov 2007

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.