Provider Demographics
NPI:1609034909
Name:G4S YOUTH SERVICES
Entity Type:Organization
Organization Name:G4S YOUTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BERNADETTE
Authorized Official - Middle Name:M
Authorized Official - Last Name:SHAIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-754-1100
Mailing Address - Street 1:9609 GAYTON RD STE 100
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23238-4900
Mailing Address - Country:US
Mailing Address - Phone:804-754-1100
Mailing Address - Fax:804-741-9515
Practice Address - Street 1:18500 SW 424TH ST
Practice Address - Street 2:
Practice Address - City:FLORIDA CITY
Practice Address - State:FL
Practice Address - Zip Code:33034-7100
Practice Address - Country:US
Practice Address - Phone:305-247-6492
Practice Address - Fax:305-247-1881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-23
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1113AD9903013245S0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children