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Organization
UPSIDE TO YOUTH DEVELOPMENT, LLC
Active
Organization
UPSIDE TO YOUTH DEVELOPMENT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT E. GAY JR. (CHIEF FINANCIAL OFFICER)
(804) 541-7894
Entity
Organization
Contact information
Practice address
943 STARLING AVE, MARTINSVILLE, VA 24112-6405
(804) 590-4453
Mailing address
943 STARLING AVE, MARTINSVILLE, VA 24112-6405
(804) 590-4453
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
1082-05-001
VA
Other
Enumeration date
12/08/2009
Last updated
12/08/2009
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