Organization
VIRGINIA HOME FOR BOYS AND GIRLS
Active
Other names
Virginia Home for Boys
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN BURGETT DOUGHERTY M.S.W. (SVP/CHIEF ADMINISTRATIVE OFFICER)
(804) 270-6566
Entity
Organization
Contact information
Practice address
2250 PUMP RD, RICHMOND, VA 23233-3508
(804) 447-3527
(804) 447-3960
Mailing address
8716 W BROAD ST, RICHMOND, VA 23294-6209
(804) 270-6566
(804) 934-9013
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
1438-14-001
VA
320800000X
Mental Illness Community Based Residential Treatment Facility
SS-78-07
VA
Other
Enumeration date
12/10/2008
Last updated
09/12/2013
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