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General NPI Number Information
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NPI Number | 1235430570
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Entity Type | Organization
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Legal Business Name | RESIDENTIAL YOUTH SERVICES, INC.
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Dates
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Enumeration Date | 11/03/2010
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Last Update Date | 11/03/2010
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Provider Practice Location Address
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Address Line | 4820 WELFORD ST
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City | ALEXANDRIA
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State | VA
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Zip | 22309-1044
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Country | US
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Telephone | 703-347-6423
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Fax | 703-347-6424
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Provider Business Mailing Address
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Address Line | 14160 NEWBROOK DR SUITE 100
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City | CHANTILLY
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State | VA
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Zip | 20151-2297
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Country | US
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Telephone | 703-841-7768
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Fax | 703-842-2341
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. DENNIS J. MANNING
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Credential | LCSW
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Telephone | 703-841-7768
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number | 292-14-007
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number | 292-14-002
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License Number State | VA
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