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Organization
ALC YOUTH & FAMILY SERVICES, LLC
Active
Organization
ALC YOUTH & FAMILY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARQUISE LONNELL ROSE (CHIEF EXECUTIVE OFFICER)
(804) 833-6399
Entity
Organization
Contact information
Practice address
14200 KENTWOOD FOREST DR, CHESTER, VA 23831-8029
(804) 454-0125
Mailing address
1124 S WEDGEMONT DR, NORTH CHESTERFIELD, VA 23236-4811
(804) 833-6399
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
2248-14-001
VA
Other
Enumeration date
06/07/2013
Last updated
06/07/2013
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