Provider Demographics
NPI:1972775500
Name:MOTHER SETON HOUSE
Entity Type:Organization
Organization Name:MOTHER SETON HOUSE
Other - Org Name:SETON YOUTH SHELTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:SALEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-963-5795
Mailing Address - Street 1:3333 VIRGINIA BEACH BLVD STE 28
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-5619
Mailing Address - Country:US
Mailing Address - Phone:757-963-5795
Mailing Address - Fax:757-340-5768
Practice Address - Street 1:642 N LYNNHAVEN RD
Practice Address - Street 2:VIRGINIA BEACH
Practice Address - City:VIRGINIA BCH
Practice Address - State:VA
Practice Address - Zip Code:23452-5810
Practice Address - Country:US
Practice Address - Phone:757-498-4673
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-24
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VASS-69-07322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children