NPI 1376879411

Atiba Youth Intervention Services/Danville LLC

Organisation Exclusive Provider Organization Danville, VA

Practice location

Address: 3401 Westover Dr STE a, Danville, VA 24541-5469
Phone: (434) 822-0084
Fax: (434) 822-0086
Mailing address: 7825 Midlothian Tpke STE 112, Richmond, VA 23235-5247

Authorised official

Name: Donald Anthony Wheeler
Title: Executive Director
Phone: (804) 272-2277

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence 118105001 (VA)

Other Exclusive Provider Organization providers in Virginia →

Registry record

NPI: 1376879411
Entity type: Organization
NPI issued: 25 Oct 2009
Record last updated: 25 Oct 2009

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.