Organization
YOUTH SERVICES OF VIRGINIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON RYAN CANNON (PRESIDENT)
(610) 742-1679
Entity
Organization
Contact information
Practice address
6802 PARAGON PL STE 210, RICHMOND, VA 23230-1655
(610) 742-1679
Mailing address
6802 PARAGON PL STE 210, RICHMOND, VA 23230-1655
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1417-05-001
VA
Other
Enumeration date
10/21/2009
Last updated
10/21/2009
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