Organization
PROFESSIONAL YOUTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEMARN BERNARD THORPE (CHEIF EXECUTIVE OFFICER)
(804) 674-4460
Entity
Organization
Contact information
Practice address
4136 WOODFIELD RD, RICHMOND, VA 23234-3450
(804) 674-4456
(804) 674-4458
Mailing address
7206 HULL STREET RD, SUITE 102A, RICHMOND, VA 23235-5827
(804) 674-4460
(804) 674-4480
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
VA
Other
Enumeration date
11/06/2006
Last updated
08/22/2020
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