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Organization
SOUTHSIDE VIRGINIA TRANINNG CENTER
Active
Organization
SOUTHSIDE VIRGINIA TRANINNG CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN A. HOLLAND JR. MD (FACILITY DIRECTOR)
(804) 524-7209
Entity
Organization
Contact information
Practice address
26317 W WASHINGTON ST, PETERSBURG, VA 23803-0030
(804) 524-7209
(804) 524-7228
Mailing address
PO BOX 4030, PETERSBURG, VA 23803-0030
(804) 524-7209
(804) 524-7228
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
28892
VA
Other
Enumeration date
01/11/2006
Last updated
08/22/2020
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