Organization
OLA HOME FOR BOYS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEITH RODNEY BROOKS (CHIEF ADMINISTRATIVE OFFICER)
(804) 343-5153
Entity
Organization
Contact information
Practice address
1802 N 22ND ST, RICHMOND, VA 23223-4434
(804) 343-5153
(804) 343-5153
Mailing address
PO BOX 2074, MECHANICSVILLE, VA 23116-0010
(804) 343-5153
(804) 343-5153
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
0021836400
VA
Other
Enumeration date
10/23/2006
Last updated
08/22/2020
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