OrganizationActive
Annzetta'S Therapeutic Home for Boys, LLC
NPI 1063609659 · Mental Illness Community Based Residential Treatment Facility · Petersburg, VA
Provider details
- NPI number
- 1063609659
- Entity type
- Organization
- Primary specialty
- Mental Illness Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Mary Harris, Office Clerk(804) 861-5182
Specialties & taxonomies
Residential Treatment Facilities
Profile Score
Detailed profile(88/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1834 Buckner St
Petersburg, VA 23805-1705
Phone: (804) 863-2661
Street-level locationGet directions
Mailing address
1834 Buckner St
Petersburg, VA 23805-1705
Registry dates
- Enumerated
- 2007-09-27
- Last updated
- 2007-10-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.