Provider Demographics
NPI:1508161175
Name:VIRGINIA YOUTH OUTREACH SERVICES, INC.
Entity Type:Organization
Organization Name:VIRGINIA YOUTH OUTREACH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:REDD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-484-5539
Mailing Address - Street 1:PO BOX 13751
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23901-8751
Mailing Address - Country:US
Mailing Address - Phone:804-484-5539
Mailing Address - Fax:
Practice Address - Street 1:1012 W 3RD ST STE D
Practice Address - Street 2:
Practice Address - City:FARMVILLE
Practice Address - State:VA
Practice Address - Zip Code:23901-3070
Practice Address - Country:US
Practice Address - Phone:804-484-5539
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-12
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health