Organization
DISTRICT 19 COMMUNITY SERVICES BOARD
Active
Organization
DISTRICT 19 COMMUNITY SERVICES BOARD
Active
Other names
District 19 Mental Health and Mental Retardation Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH E. HUBBARD C.P.A. (EXECUTIVE DIRECTOR)
(804) 862-8054
Entity
Organization
Contact information
Practice address
20 W BANK ST, SUITE 2, PETERSBURG, VA 23803-3279
(804) 862-8054
(804) 863-1665
Mailing address
20 W BANK ST, SUITE 2, PETERSBURG, VA 23803-3279
(804) 862-8054
(804) 863-1665
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
252Y00000X
Early Intervention Provider Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4945280
—
VA
Enumeration date
04/25/2006
Last updated
07/30/2009
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