Organization · Type 2 NPI
Annzetta's Therapeutic Home for Boys, LLC
Mental Illness Community Based Residential Treatment Facility · Petersburg, VA
NPI number
1063609659
Active
Practice location
1834 Buckner St
Petersburg, VA 23805-1705
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Illness Community Based Residential Treatment Facility Primary | 320800000X | None listed |
Mental Illness Community Based Residential Treatment Facility: A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
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About NPI 1063609659
Annzetta's Therapeutic Home for Boys, LLC's National Provider Identifier is 1063609659, issued on Sep 27, 2007. The primary taxonomy on file is Mental Illness Community Based Residential Treatment Facility (320800000X), and the practice location is in Petersburg, VA. The record was last updated on Oct 25, 2007.