Organization
UPSIDE TO YOUTH DEVELOPMENT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRANDON C HUDSON (CEO)
(804) 541-7894
Entity
Organization
Contact information
Practice address
222 N MAIN ST, SUITE 312, HOPEWELL, VA 23860-2712
(804) 541-7894
(804) 841-7895
Mailing address
222 N MAIN ST, SUITE 312, HOPEWELL, VA 23860-2712
(804) 541-7894
(804) 841-7895
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1082-05
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1082
DBDS
VA
Enumeration date
02/25/2010
Last updated
02/25/2010
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