Organization
THE BRAMBLEX
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CLYDE H FORREST (OWNER/DIRECTOR)
(804) 725-3800
Entity
Organization
Contact information
Practice address
300 BELLA TERRA ROAD, NORTH, VA 23128-0126
(804) 725-3800
(804) 725-3999
Mailing address
PO BOX 126, NORTH, VA 23128-0126
(804) 725-3800
(804) 725-3999
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/09/2006
Last updated
08/22/2020
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