NPI 1154330942

Southside Virginia Training Center

Organisation Intellectual Disabilities Intermediate Care Facility Petersburg, VA

Practice location

Address: 26317 West Washington Street, Petersburg, VA 23803
Phone: (804) 524-7209
Fax: (804) 524-7228

Authorised official

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

Registered specialties

Intellectual Disabilities Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 315P00000X

Other Intermediate Care Facility, Intellectual Disabilities providers in Virginia →

Registry record

NPI: 1154330942
Entity type: Organization
NPI issued: 8 Aug 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.