Organization
THE FOUNTAIN 4 YOUTH THERAPEUTIC SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD C HILL (COUNSELOR)
(804) 508-0904
Entity
Organization
Contact information
Practice address
3108 N PARHAM RD, HENRICO, VA 23294-4421
(804) 508-0904
Mailing address
3108 N PARHAM RD, HENRICO, VA 23294-4421
(804) 508-0904
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
10/12/2022
Last updated
10/12/2022
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