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Organization

OPTIMUM YOUTH SERVICES LLC

Active
Other names
Gabrielle's House
Organization subpart
No

Provider details

NPI number
Authorized official
MONICA BRATHWAITE (CHIEF ADMINISTRATIVE OFFICER)
(804) 525-8069
Entity
Organization

Contact information

Practice address
725 S PROVIDENCE RD, NORTH CHESTERFIELD, VA 23236-3337
(804) 525-4069
Mailing address
10524 BRIGHTSTONE DR, MIDLOTHIAN, VA 23112-1570
(804) 986-8392

Taxonomy

Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary

Other

Enumeration date
08/12/2020
Last updated
08/12/2020
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