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Organization

COMMONWEALTH OF VIRGINIA CENTRAL STATE HOSPITAL

Active
Parent organization
CENTRAL STATE HOSPITAL
Other names
Central State Hopsital
Organization subpart
Yes

Provider details

NPI number
Legal business name
CENTRAL STATE HOSPITAL
Authorized official
DR. CHARLES DAVIS (FACILITY DIRECTOR)
(804) 524-7000
Entity
Organization

Contact information

Practice address
26317 W WASHINGTON ST, PETERSBURG, VA 23803
(804) 524-7000
Mailing address
PO BOX 4030, PETERSBURG, VA 23803-0030

Taxonomy

Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
49410701
VA
Enumeration date
09/05/2006
Last updated
08/01/2007
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