Organization
YOUTH VILLAGES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUSTIN HICKS (DISTRICT MANAGER)
(703) 516-6951
Entity
Organization
Contact information
Practice address
1911 FORT MYER DR, 305, ARLINGTON, VA 22209-1607
(703) 516-6951
Mailing address
1911 N FORT MYER DRIVE, 305, ARLINGTON, VA 22209
(703) 516-6951
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
BLC10015648503
VA
Other
Enumeration date
10/26/2015
Last updated
10/26/2015
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