Healthcare Provider Details

I. General information

NPI: 1184807588
Provider Name (Legal Business Name): FRANKLIN COUNTY YOUTH CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 S MAIN ST
ROCKY MOUNT VA
24151-1549
US

IV. Provider business mailing address

70 S MAIN ST P.O. BOX 481
ROCKY MOUNT VA
24151-1549
US

V. Phone/Fax

Practice location:
  • Phone: 540-483-8008
  • Fax: 540-483-3431
Mailing address:
  • Phone: 540-483-8008
  • Fax: 540-483-3431

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateVA

VIII. Authorized Official

Name: MR. MICHAEL PATTERSON SR.
Title or Position: DIRECTOR
Credential:
Phone: 540-483-4709