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Organization

VALLEY OF YOUTH

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. ROLENA WILLIAMS HARRISON (EXECTIVE DIRACTOR)
(864) 836-5849
Entity
Organization

Contact information

Practice address
352 SPRING PARK RD, MARIETTA, SC 29661-9229
(864) 836-5849
Mailing address
352 SPRING PARK RD, P.O. BOX 88, MARIETTA, SC 29661-9229
(864) 836-5849

Taxonomy

Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
SR-1002962001-GH
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
891MXH
SC
Enumeration date
12/13/2006
Last updated
08/22/2020
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