OrganizationActive
Dominion Youth Services
NPI 1952562811 · Mental Illness Community Based Residential Treatment Facility · Roanoke, VA
Provider details
- NPI number
- 1952562811
- Entity type
- Organization
- Primary specialty
- Mental Illness Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Gl Pulliam, Director of Residential(804) 285-9838
- License
- 40614077 (VA)
Specialties & taxonomies
Residential Treatment Facilities
Profile Score
Detailed profile(87/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 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
4802 Northridge Lane
Roanoke, VA 24019
Phone: (540) 366-3080
Fax: (540) 366-3081
Street-level locationGet directions
Mailing address
8401 Mayland Drive
Richmond, VA 23294
Other names (DBA / former)
- Doing business as
- Dominion Youth Services Residential
Registry dates
- Enumerated
- 2008-06-23
- Last updated
- 2008-06-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.