Healthcare Provider Details

I. General information

NPI: 1194844670
Provider Name (Legal Business Name): VIRGINIA HOME FOR BOYS & GIRLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8716 W BROAD ST
RICHMOND VA
23294-6209
US

IV. Provider business mailing address

8716 W BROAD ST
RICHMOND VA
23294-6209
US

V. Phone/Fax

Practice location:
  • Phone: 804-270-6566
  • Fax: 804-934-9013
Mailing address:
  • Phone: 804-270-6566
  • Fax: 804-934-9013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MR. CY RILEE
Title or Position: DIR OF FINANCE AND ADMINISTRATION
Credential:
Phone: 804-270-6566