Organization · Type 2 NPI
Southside Virginia Training Center
Intellectual Disabilities Intermediate Care Facility · Petersburg, VA
NPI number
1154330942
Active
Practice location
26317 West Washington Street
Petersburg, VA 23803
Fax (804) 524-7228
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual Disabilities Intermediate Care Facility Primary | 315P00000X | None listed |
Intellectual Disabilities Intermediate Care Facility: An intermediate care facility providing services for individuals with intellectual disabilities.
5 other providers at this address
- Anwar Kamal Abdullah, MDInternal Medicine Physician Petersburg, VA NPI 1184650947
- Dafferlin Juanita Barnard-Dupree, MDForensic Psychiatry Physician Petersburg, VA NPI 1669450912
- Deborah Goodrich Cousins, CPHTPharmacy Technician Petersburg, VA NPI 1669450276
- Lori Vaughan MazsurePharmacist Petersburg, VA NPI 1467430751
- Nancy Clay Cook, RPHPharmacist Petersburg, VA NPI 1396723987
About NPI 1154330942
Southside Virginia Training Center's National Provider Identifier is 1154330942, issued on Aug 8, 2006. The primary taxonomy on file is Intellectual Disabilities Intermediate Care Facility (315P00000X), and the practice location is in Petersburg, VA. The record was last updated on Aug 22, 2020.