Provider Demographics
NPI:1821399882
Name:VIRGINIA HOME FOR BOYS AND GIRLS
Entity Type:Organization
Organization Name:VIRGINIA HOME FOR BOYS AND GIRLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLINICAL AND COMMUNITY
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-270-6566
Mailing Address - Street 1:8716 W BROAD ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23294-6209
Mailing Address - Country:US
Mailing Address - Phone:804-270-6566
Mailing Address - Fax:804-934-9013
Practice Address - Street 1:8716 W BROAD ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23294-6209
Practice Address - Country:US
Practice Address - Phone:804-270-6566
Practice Address - Fax:804-934-9013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-08
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1438-05-001251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health