Organization
YOUTH PATHWAYS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HANNIBAL CLITUS TUCK (PROGRAM DIRECTOR)
(804) 922-1664
Entity
Organization
Contact information
Practice address
1401 TURNER RD, RICHMOND, VA 23225-6934
(804) 271-1883
(804) 271-1884
Mailing address
1401 TURNER RD, RICHMOND, VA 23225-6934
(804) 271-1883
(804) 271-1884
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/11/2008
Last updated
02/11/2008
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