Organization
DOMINION HEALTH MEDICAL ASSOCIATES LTD
Active
Other names
SENTARA BEHAVIORAL HEALTH SPECIALISTS
Organization subpart
No
Provider details
NPI number
Authorized official
CECIL HAZELWOOD (MANAGER/DHG)
(434) 517-3515
Entity
Organization
Contact information
Practice address
504 WILBORN AVE, SOUTH BOSTON, VA 24592-3120
(434) 517-3400
Mailing address
PO BOX 860, SOUTH BOSTON, VA 24592-0860
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/24/2018
Last updated
09/24/2018
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