Provider Demographics
NPI:1710185897
Name:PATRICK HENRY BOYS AND GIRLS PLANTATION, INC
Entity Type:Organization
Organization Name:PATRICK HENRY BOYS AND GIRLS PLANTATION, INC
Other - Org Name:HOPE FOR TOMORROW COUNSELING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-376-2006
Mailing Address - Street 1:1617A ENTERPRISE DR
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-5797
Mailing Address - Country:US
Mailing Address - Phone:434-239-4949
Mailing Address - Fax:434-239-4955
Practice Address - Street 1:1617A ENTERPRISE DR
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-5797
Practice Address - Country:US
Practice Address - Phone:434-239-4949
Practice Address - Fax:434-239-4955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003730101YP2500X
VA0701003872101YP2500X
VA0701003238101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty