Organization
SOUTHSIDE VIRGINIA TRAINING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN ALFRED HOLLAND JR. MD (FACILITY DIRECTOR)
(804) 524-7209
Entity
Organization
Contact information
Practice address
26317 WEST WASHINGTON STREET, PETERSBURG, VA 23803
(804) 524-7209
(804) 524-7228
Mailing address
26317 WEST WASHINGTON STREET, PETERSBURG, VA 23803
(804) 524-7209
(804) 524-7228
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Enumeration date
08/08/2006
Last updated
08/22/2020
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