Organization
YOUTH TO WISDOM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY BROWN BROOKS ADVOCATE (VOLUNTEER ADMINISTRATOR)
(804) 690-8177
Entity
Organization
Contact information
Practice address
1611 WHITE CEDAR LN, NORTH CHESTERFIELD, VA 23235-5449
(804) 690-8177
(804) 745-7183
Mailing address
1611 WHITE CEDAR LN, NORTH CHESTERFIELD, VA 23235-5449
(804) 690-8177
(804) 745-7183
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
1401112429
VA
Other
Enumeration date
03/07/2016
Last updated
03/07/2016
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