Organization
GABRIELLE'S HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MONICA BRATHWAITE M.S.E (CHIEF ADMINISTRATIVE OFFICER)
(804) 763-1474
Entity
Organization
Contact information
Practice address
725 S PROVIDENCE RD, RICHMOND, VA 23236-3337
(804) 763-1474
Mailing address
10524 BRIGHTSTONE DR, MIDLOTHIAN, VA 23112-1570
(804) 763-1474
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
SS-395/5431-08
VA
Other
Enumeration date
06/15/2008
Last updated
06/15/2008
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