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General NPI Number Information
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NPI Number | 1417214149
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Entity Type | Organization
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Legal Business Name | TURNING POINT HOME FOR BOYS, INC.
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Dates
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Enumeration Date | 04/19/2012
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Last Update Date | 04/19/2012
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Provider Practice Location Address
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Address Line | 4701 STONEHURST DR
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City | WOODBRIDGE
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State | VA
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Zip | 22192-5727
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Country | US
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Telephone | 703-580-6372
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Fax | 703-580-9260
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Provider Business Mailing Address
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Address Line | 4701 STONEHURST DR
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City | WOODBRIDGE
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State | VA
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Zip | 22192-5727
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Country | US
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Telephone | 703-580-6372
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Fax | 703-580-9260
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | TERRY BUTLER JR.
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Credential |
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Telephone | 703-580-6372
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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 | CO-339-09
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License Number State | VA
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