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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