Organization
HALO, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HARRY LEGROS QMRP/QMHP (EXECUTIVE DIRECTOR)
(804) 733-9140
Entity
Organization
Contact information
Practice address
1857A FORT MAHONE ST, PETERSBURG, VA 23805-2761
(804) 733-9140
(804) 733-9216
Mailing address
1857A FORT MAHONE ST, P. O. BOX 28, PETERSBURG, VA 23805-2761
(804) 733-9140
(804) 733-9216
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
523-01
VA
Other
Enumeration date
02/09/2006
Last updated
08/22/2020
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