Organization
DISTRICT 19 COMMUNITY SERVICE BOARD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELEANOR WILKINS YATES (LPN)
(804) 541-1829
Entity
Organization
Contact information
Practice address
1308 LEMONWOOD DR, HOPEWELL, VA 23860-7619
(804) 541-1829
Mailing address
1308 LEMONWOOD DR, HOPEWELL, VA 23860-7619
(804) 541-1829
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
0002044952
VA
323P00000X
Psychiatric Residential Treatment Facility
Primary
0002044952
VA
Other
Enumeration date
05/20/2010
Last updated
05/20/2010
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