OrganizationActive
Starting Point
NPI 1124107966 · Emotionally Disturbed Childrens' Residential Treatment Facility · Glen Allen, VA
Provider details
- NPI number
- 1124107966
- Entity type
- Organization
- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Jackie Woodley, Program Director(804) 756-0159
Specialties & taxonomies
Residential Treatment Facilities
Practice location
10556 Courtney Rd
Glen Allen, VA 23060-3011
Phone: (804) 756-0159
Fax: (804) 756-0159
Approximate (ZIP-level) locationGet directions
Mailing address
10556 Courtney Rd
Glen Allen, VA 23060-3011
Registry dates
- Enumerated
- 2006-11-03
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.