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Organization
JEFFERSON TRAIL TREATMENT CENTER FOR CHILDREN
Active
Organization
JEFFERSON TRAIL TREATMENT CENTER FOR CHILDREN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKI TENCH BOD (BUSINESS OFFICE DIRECTOR)
(615) 250-0283
Entity
Organization
Contact information
Practice address
2101 ARLINGTON BLVD, CHARLOTTESVILLE, VA 22903-1521
(615) 250-0283
(615) 250-0000
Mailing address
110 WESTWOOD PL, SUITE 100, BRENTWOOD, TN 37027-5075
(615) 250-0283
(615) 250-0000
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
63014001
VA
Other
Enumeration date
06/30/2011
Last updated
06/30/2011
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