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General NPI Number Information
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NPI Number | 1255455002
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Entity Type | Organization
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Legal Business Name | HEARTFIELD HOME FOR BOYS, INC.
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3815 PHEASANT HOLLOW DR
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City | RICHMOND
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State | VA
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Zip | 23231-7583
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Country | US
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Telephone | 804-795-9191
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Fax |
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Provider Business Mailing Address
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Address Line | 3815 PHEASANT HOLLOW DR
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City | RICHMOND
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State | VA
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Zip | 23231-7583
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Country | US
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Telephone | 804-795-9191
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Fax |
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Authorized Official
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Title or Position | CHEIF ADMINISTRATIVE OFFICER
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Name | MS. LINDA PORTER COLES
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Credential | LCSW
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Telephone | 804-795-9191
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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 | 87214001
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License Number State | VA
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