NPI 1811180458

Dominion Youth Services

Organisation Mental Illness Community Based Residential Treatment Facility Roanoke, VA

Practice location

Address: 7002 Dallas Rd, Roanoke, VA 24019-1510
Phone: (540) 366-5073
Fax: (540) 366-5074
Mailing address: PO Box 70296, Richmond, VA 23255-0296

Authorised official

Name: Gl Pulliam
Title: Director of Residential
Phone: (804) 285-9838

Registered specialties

Mental Illness Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320800000X Licence 406-14-004 (VA)

Other Community Based Residential Treatment Facility, Mental Illness providers in Virginia →

Registry record

NPI: 1811180458
Entity type: Organization
NPI issued: 27 Aug 2007
Record last updated: 27 Aug 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.