Dominion Youth Services Residential

LBN: Dominion Youth Services
Dominion Youth Services Residential is an health care organization with primary practice located at 4802 Northridge Lane , Roanoke VA 24019. The organization recently has only one registered license in Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness, which is considered as the primary health care specialty. Dominion Youth Services can be contacted via phone (540) 366-3080, or through Pulliam, Gl via phone (804) 285-9838.

Contact Information

Primary practice address
4802 Northridge Lane Roanoke VA 24019
Phone: (540) 366-3080
Fax: (540) 366-3081
Website:
Map and Directions
Authorized official contact:
Name: Pulliam, Gl MS
Phone: (804) 285-9838

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness 320800000X 40614077 Virginia

Profile Details

NPI number 1952562811
LBN Legal business name Dominion Youth Services
DBA Doing business as Dominion Youth Services Residential
Authorized official Pulliam, Gl MS
Entity Organization
Organization subpart 1 No
Enumeration date Jun 23rd, 2008
Last updated Jun 23rd, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952562811 NPPES
Virginia Other 406-14-077 DMH LICENSE

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