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General NPI Number Information
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NPI Number | 1336619667
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Entity Type | Organization
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Legal Business Name | THE DISCOVERY SCHOOL OF VIRGINIA, INC.
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Dates
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Enumeration Date | 11/29/2018
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Last Update Date | 11/29/2018
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Provider Practice Location Address
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Address Line | 2697 COPPER MINE ROAD
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City | DILLWYN
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State | VA
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Zip | 23936-2393
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Country | US
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Telephone | 434-983-5616
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1160
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City | DILLWYN
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State | VA
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Zip | 23936-1160
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Country | US
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Telephone | 434-983-5616
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MARK MELLUSI
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Credential |
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Telephone | 434-983-5616
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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 |
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License Number State |
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