Organization
ATIBA YOUTH INTERVENTION SERVICES/DANVILLE LLC
Active
Organization
ATIBA YOUTH INTERVENTION SERVICES/DANVILLE LLC
Active
Parent organization
ATIBA YOUTH INTERVENTION SERVICES LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ATIBA YOUTH INTERVENTION SERVICES LLC
Authorized official
MR. DONALD ANTHONY WHEELER (EXECUTIVE DIRECTOR)
(804) 272-2277
Entity
Organization
Contact information
Practice address
3401 WESTOVER DR STE A, DANVILLE, VA 24541-5469
(434) 822-0084
(434) 822-0086
Mailing address
7825 MIDLOTHIAN TPKE STE 112, RICHMOND, VA 23235-5247
(804) 272-2277
(804) 272-2294
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
118105001
VA
Other
Enumeration date
10/25/2009
Last updated
10/25/2009
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